Provider Demographics
NPI:1427399872
Name:ROBINSON, LISA (CBD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N FISK ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-4545
Mailing Address - Country:US
Mailing Address - Phone:920-857-4039
Mailing Address - Fax:
Practice Address - Street 1:520 N FISK ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-4545
Practice Address - Country:US
Practice Address - Phone:920-857-4039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula