Provider Demographics
NPI:1295285666
Name:TUCKER, ROBIN JENNIFER PASS (DNP MPH CNM, WHNP-BC)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:JENNIFER PASS
Last Name:TUCKER
Suffix:
Gender:X
Credentials:DNP MPH CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 H ST NE STE 1107
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3627
Mailing Address - Country:US
Mailing Address - Phone:301-241-8181
Mailing Address - Fax:636-205-1732
Practice Address - Street 1:3720 FARRAGUT AVE STE 202
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2110
Practice Address - Country:US
Practice Address - Phone:301-241-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC003669363LW0102X
DCRN1016825363LW0102X, 367A00000X, 367A00000X
MDAC003674367A00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health