Provider Demographics
NPI:1619487626
Name:ROBINSON, LAQUADRIA SYMONE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAQUADRIA
Middle Name:SYMONE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:LAQUADRIA
Other - Middle Name:S
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:2886 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3853
Mailing Address - Country:US
Mailing Address - Phone:205-641-4210
Mailing Address - Fax:
Practice Address - Street 1:1001 CECELIA DR STE 200
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-2546
Practice Address - Country:US
Practice Address - Phone:262-260-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8049-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health