Provider Demographics
NPI:1013292333
Name:ROBINSON, JENNY LEE (MS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:LEE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:MS
Other - First Name:JENNY
Other - Middle Name:LEE
Other - Last Name:CREECY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PA-C
Mailing Address - Street 1:1558 HICKS EDGEN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-7041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:980 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5251
Practice Address - Country:US
Practice Address - Phone:931-905-1001
Practice Address - Fax:931-905-0410
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant