Provider Demographics
NPI:1326089921
Name:FEELY, ROBYN (NP)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:FEELY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:SIMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:
Practice Address - Street 1:2104 W LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4357
Practice Address - Country:US
Practice Address - Phone:804-354-8108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184935363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401555000Medicaid
DC500029867Medicare ID - Type UnspecifiedRAILROAD
DCP33316Medicare UPIN
MD401555000Medicaid
DC034295700Medicare ID - Type Unspecified