Provider Demographics
NPI:1205988086
Name:ROBINSON, DONNA (MS RD)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7416 CARATH CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1606
Mailing Address - Country:US
Mailing Address - Phone:703-644-4461
Mailing Address - Fax:703-644-4461
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:STE 303
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-644-4461
Practice Address - Fax:703-644-4461
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANOT APPLICABLE133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491105Medicare ID - Type Unspecified
VA4263656Medicare UPIN
VA211638Medicare UPIN
VI1516207002Medicare UPIN