Provider Demographics
NPI:1376553115
Name:ROBINSON-LEE, KRISTY RENEE (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:RENEE
Last Name:ROBINSON-LEE
Suffix:
Gender:F
Credentials:OD
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 1000
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-1000
Mailing Address - Country:US
Mailing Address - Phone:434-846-7822
Mailing Address - Fax:
Practice Address - Street 1:5076 S AMHERST HWY
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-2491
Practice Address - Country:US
Practice Address - Phone:434-846-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001333152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010167141Medicaid
VA1252770001Medicare NSC
VA010167141Medicaid
VA008114S74Medicare PIN