Provider Demographics
NPI:1710742333
Name:SMITH, ROBIN TYSHIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:TYSHIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5641 SAXON DR
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-4169
Mailing Address - Country:US
Mailing Address - Phone:216-394-1493
Mailing Address - Fax:
Practice Address - Street 1:5641 SAXON DR
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-4169
Practice Address - Country:US
Practice Address - Phone:216-394-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.531399163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse