Provider Demographics
NPI:1790124618
Name:ROBINSON, MICHAEL EVERETT (RN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EVERETT
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:IHS HOUSING COMPOUND, UNIT 69, HWY 264, MILE MARKER 402
Mailing Address - Street 2:BOX 843
Mailing Address - City:KEAMS CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:86034
Mailing Address - Country:US
Mailing Address - Phone:248-990-4556
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY 264 MILE POST 388, POLACCA, AZ 86042
Practice Address - Street 2:HOPI HEALTH CARE CENTER (IHS)
Practice Address - City:POLACCA
Practice Address - State:AZ
Practice Address - Zip Code:86042
Practice Address - Country:US
Practice Address - Phone:248-990-4556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704280889163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse