Provider Demographics
NPI:1609006816
Name:ROBINSON, EVETTE DIANE
Entity Type:Individual
Prefix:
First Name:EVETTE
Middle Name:DIANE
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 1:59 LINDSLEY PL
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1109
Mailing Address - Country:US
Mailing Address - Phone:973-676-0689
Mailing Address - Fax:
Practice Address - Street 1:59 LINDSLEY PL
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1109
Practice Address - Country:US
Practice Address - Phone:973-676-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY546782163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse