Provider Demographics
NPI:1497122899
Name:ROBINSON, CARLY H (CPNP-AC)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:H
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:W
Other - Last Name:HODNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-AC
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-4987
Practice Address - Fax:804-628-0366
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172970363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care