Provider Demographics
NPI:1447592860
Name:ROBINSON, JENNIFER MCPEAK (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MCPEAK
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 RILEY HOSPITAL DR
Mailing Address - Street 2:ROOM 5867
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5109
Mailing Address - Country:US
Mailing Address - Phone:317-944-4034
Mailing Address - Fax:317-944-1476
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:ROOM 5867
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-944-4034
Practice Address - Fax:317-944-1476
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program