Provider Demographics
NPI:1265464879
Name:ROBINSON, MICHAELA (APRN)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MAIDEN CHOICE LN
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5968
Mailing Address - Country:US
Mailing Address - Phone:410-882-3240
Mailing Address - Fax:410-661-5093
Practice Address - Street 1:8800 WALTHER BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-9001
Practice Address - Country:US
Practice Address - Phone:410-882-3240
Practice Address - Fax:410-661-5093
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR123555364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
0943ER-841177-04OtherCARFIRST BCBS OF MD
8301159OtherEVERCARE
84117702OtherBCBS
84117703OtherBCBS
0032OtherCAREFIRST
MD788002200Medicaid
093NSE-841177-03OtherCAREFIRST BCBS OF MD
093NER-841177-03OtherCAREFIRST BCBS OF MD
9676-0052OtherCAREFIRST BCBS OF DC
MD960801001Medicaid
S88121Medicare UPIN
890001126Medicare PIN
E098Medicare PIN
MD788002200Medicaid