Provider Demographics
NPI:1255085460
Name:ROBINSON, JASON PAUL (RN)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:PAUL
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5409 WAKEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5333
Mailing Address - Country:US
Mailing Address - Phone:847-445-6612
Mailing Address - Fax:
Practice Address - Street 1:5409 WAKEFIELD AVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-5333
Practice Address - Country:US
Practice Address - Phone:847-445-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI197884-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse