Provider Demographics
NPI:1811281769
Name:ROBINSON, MICHELE LEE (RPH)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LEE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9777 76TH ST
Mailing Address - Street 2:T-2251
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1990
Mailing Address - Country:US
Mailing Address - Phone:262-842-1171
Mailing Address - Fax:262-842-1181
Practice Address - Street 1:9777 76TH ST
Practice Address - Street 2:T-2251
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1990
Practice Address - Country:US
Practice Address - Phone:262-842-1171
Practice Address - Fax:262-842-1181
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11662-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist