Provider Demographics
NPI:1558547919
Name:ROBINSON, MICHELLE D (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2869 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6087
Mailing Address - Country:US
Mailing Address - Phone:501-327-2611
Mailing Address - Fax:501-336-9763
Practice Address - Street 1:2869 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6087
Practice Address - Country:US
Practice Address - Phone:501-327-2611
Practice Address - Fax:501-336-9763
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-261363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP113Medicare PIN