Provider Demographics
NPI:1710525159
Name:ROBINSON, NIKITA (SENIOR COSMETOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:NIKITA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:SENIOR COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12743 MILLSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1636
Mailing Address - Country:US
Mailing Address - Phone:443-739-7647
Mailing Address - Fax:
Practice Address - Street 1:12743 MILLSTREAM DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1636
Practice Address - Country:US
Practice Address - Phone:443-739-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107710174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist