Provider Demographics
NPI:1629700224
Name:ROBINSON, KARINA M (CPM LDEM)
Entity Type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CPM LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 E 650 S
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2454
Mailing Address - Country:US
Mailing Address - Phone:470-236-8520
Mailing Address - Fax:
Practice Address - Street 1:765 E 650 S
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-2454
Practice Address - Country:US
Practice Address - Phone:470-236-8520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175M00000X
UT367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No175M00000XOther Service ProvidersMidwife, Lay