Provider Demographics
NPI:1184404741
Name:ROBLES-NEGRON, KEISHLA (DC)
Entity type:Individual
Prefix:
First Name:KEISHLA
Middle Name:
Last Name:ROBLES-NEGRON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2704
Mailing Address - Country:US
Mailing Address - Phone:704-940-9400
Mailing Address - Fax:704-940-4001
Practice Address - Street 1:5344 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2704
Practice Address - Country:US
Practice Address - Phone:704-940-9400
Practice Address - Fax:704-940-4001
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor