Provider Demographics
NPI:1497132880
Name:ROBINSON, KENDRA (MSN, FNP-BC, CDE)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSN, FNP-BC, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 OLDE TOWNE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8111
Mailing Address - Country:US
Mailing Address - Phone:757-259-3258
Mailing Address - Fax:757-220-1953
Practice Address - Street 1:5249 OLDE TOWNE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8111
Practice Address - Country:US
Practice Address - Phone:757-259-3258
Practice Address - Fax:757-220-1953
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001199696163WD0400X
VA0024175532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA21210487OtherCDE
VA0024175532OtherBOARD OF NURSING
VA0017144465OtherBOARD OF NURSING