Provider Demographics
NPI:1538688072
Name:BROWN, ROBIN MICHELE
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MICHELE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MICHELE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-4526
Mailing Address - Country:US
Mailing Address - Phone:318-539-1010
Mailing Address - Fax:318-539-4085
Practice Address - Street 1:2001 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075-4526
Practice Address - Country:US
Practice Address - Phone:318-539-1010
Practice Address - Fax:318-539-4085
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1661133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered