Provider Demographics
NPI:1336916915
Name:ROBINSON SMITH, EBONY DANIELLE
Entity Type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:DANIELLE
Last Name:ROBINSON SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 KERRY DR
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-2525
Mailing Address - Country:US
Mailing Address - Phone:870-559-6635
Mailing Address - Fax:
Practice Address - Street 1:206 KERRY DR
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-2525
Practice Address - Country:US
Practice Address - Phone:870-559-6635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy