Provider Demographics
NPI:1780470401
Name:ROBINSON, KENYARDAR S (RN)
Entity type:Individual
Prefix:
First Name:KENYARDAR
Middle Name:S
Last Name:ROBINSON
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 176TH ST E STE B103
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-9303
Mailing Address - Country:US
Mailing Address - Phone:804-549-9859
Mailing Address - Fax:253-528-4071
Practice Address - Street 1:5614 176TH ST E STE B103
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-9303
Practice Address - Country:US
Practice Address - Phone:804-549-9859
Practice Address - Fax:253-528-4071
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61089005163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse