Provider Demographics
NPI:1336673656
Name:ROBINSON, RICHARD (CRNP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4274 CAHABA HEIGHTS CT STE 130
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5724
Mailing Address - Country:US
Mailing Address - Phone:205-977-8484
Mailing Address - Fax:
Practice Address - Street 1:4274 CAHABA HEIGHTS CT STE 130
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5724
Practice Address - Country:US
Practice Address - Phone:205-977-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-127370390200000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program