Provider Demographics
NPI:1770271108
Name:ROBINSON, MEGHAN NICHOLE (PTA)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:NICHOLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:NICHOLE
Other - Last Name:ERWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:2745 EXECUTIVE PARK NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-2723
Mailing Address - Country:US
Mailing Address - Phone:423-479-8899
Mailing Address - Fax:
Practice Address - Street 1:2745 EXECUTIVE PARK NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2723
Practice Address - Country:US
Practice Address - Phone:423-479-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6578225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant