Provider Demographics
NPI:1801592571
Name:ROBINSON, BRENDA GAIL
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:GAIL
Last Name:ROBINSON
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 1:5112 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37914-3778
Mailing Address - Country:US
Mailing Address - Phone:865-919-7322
Mailing Address - Fax:
Practice Address - Street 1:5112 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-3778
Practice Address - Country:US
Practice Address - Phone:865-919-7322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDP79163347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle