Provider Demographics
NPI:1760247282
Name:ROBINSON, DAIJAH MONIQUE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:DAIJAH
Middle Name:MONIQUE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 BALCH RD APT 12209
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9811
Mailing Address - Country:US
Mailing Address - Phone:931-561-7158
Mailing Address - Fax:
Practice Address - Street 1:7500 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9554
Practice Address - Country:US
Practice Address - Phone:256-964-8338
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
AL1-180719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty