Provider Demographics
NPI:1609146919
Name:ROBINSON, MARK GEORGE (CRNP)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:GEORGE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MELISSA LN
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1255
Mailing Address - Country:US
Mailing Address - Phone:215-760-4887
Mailing Address - Fax:
Practice Address - Street 1:450 CRESSON BOULEVARD
Practice Address - Street 2:SUITE 110
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456
Practice Address - Country:US
Practice Address - Phone:610-728-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily