Provider Demographics
NPI:1417365677
Name:ROBINSON, KELLY (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 POTOMAC DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9597
Mailing Address - Country:US
Mailing Address - Phone:724-344-1183
Mailing Address - Fax:
Practice Address - Street 1:20399 ROUTE 19 STE 120
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6135
Practice Address - Country:US
Practice Address - Phone:412-432-7909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN78684-NP-C363LF0000X
PASP013948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily