Provider Demographics
NPI:1609650035
Name:ROBINSON, SHAMEL TYIESHA
Entity Type:Individual
Prefix:
First Name:SHAMEL
Middle Name:TYIESHA
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 1:1001 1ST ST NW APT 508
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2291
Mailing Address - Country:US
Mailing Address - Phone:240-714-9159
Mailing Address - Fax:
Practice Address - Street 1:2022 MARYLAND AVE NE APT 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3167
Practice Address - Country:US
Practice Address - Phone:202-200-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant