Provider Demographics
NPI:1851554406
Name:ROBINSON, JERROL J (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JERROL
Middle Name:J
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JERROL
Other - Middle Name:J
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3722 BRIDGES ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2944
Mailing Address - Country:US
Mailing Address - Phone:252-499-8450
Mailing Address - Fax:
Practice Address - Street 1:3722 BRIDGES ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2944
Practice Address - Country:US
Practice Address - Phone:252-499-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5674P363L00000X
OH38457363LF0000X
WV62371363LF0000X
NC5010705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000572232OtherANTHEM BCBS
WV3810017049Medicaid
WVNP34571Medicare PIN
KY0641239Medicare PIN