Provider Demographics
NPI:1558473892
Name:ROBLES, ADRIENNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:
Last Name:ROBLES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N BEAUREGARD ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1723
Mailing Address - Country:US
Mailing Address - Phone:703-436-1215
Mailing Address - Fax:
Practice Address - Street 1:1500 N BEAUREGARD ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1723
Practice Address - Country:US
Practice Address - Phone:703-436-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN281762363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYQ75277Medicare UPIN