Provider Demographics
NPI:1790548246
Name:ROBINSON, JENNIFER LATHAM (CFM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LATHAM
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BROAD ST STE 108
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3573
Mailing Address - Country:US
Mailing Address - Phone:919-802-8020
Mailing Address - Fax:919-251-9275
Practice Address - Street 1:1200 BROAD ST STE 108
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3573
Practice Address - Country:US
Practice Address - Phone:919-802-8020
Practice Address - Fax:919-251-9275
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter