Provider Demographics
NPI:1326673898
Name:ROBINSON, HEATHER (CPM)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141004
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-5004
Mailing Address - Country:US
Mailing Address - Phone:313-585-6335
Mailing Address - Fax:313-429-7660
Practice Address - Street 1:5913 BEACONSFIELD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-3128
Practice Address - Country:US
Practice Address - Phone:313-585-6335
Practice Address - Fax:313-429-7660
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7601000027176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife