Provider Demographics
NPI:1578622692
Name:ROBINSON, DEBRA KAY
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:KAY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:204 WEST MAIN STREET
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-0090
Mailing Address - Country:US
Mailing Address - Phone:615-597-2291
Mailing Address - Fax:615-597-7566
Practice Address - Street 1:204 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-0090
Practice Address - Country:US
Practice Address - Phone:615-597-2291
Practice Address - Fax:615-597-7566
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000492332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0031825OtherBCBS
TN0031825OtherBCBS