Provider Demographics
NPI:1629514559
Name:ROBINSON, GINA ANTOINETTE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:ANTOINETTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:ANTOINETTE
Other - Last Name:MELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1928 WEDDINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WEDDINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8318
Mailing Address - Country:US
Mailing Address - Phone:704-844-0505
Mailing Address - Fax:704-844-0220
Practice Address - Street 1:1928 WEDDINGTON RD
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28104-8318
Practice Address - Country:US
Practice Address - Phone:704-844-0505
Practice Address - Fax:704-844-0220
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06954363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant