Provider Demographics
NPI:1013360569
Name:HEWITT, ROBIN
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:948 BANYAN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5204
Mailing Address - Country:US
Mailing Address - Phone:757-359-0005
Mailing Address - Fax:
Practice Address - Street 1:18310 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:STE 300 # 1016
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879
Practice Address - Country:US
Practice Address - Phone:240-261-7184
Practice Address - Fax:240-261-7194
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173752363LF0000X
MDR259368363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily