Provider Demographics
NPI:1932284221
Name:ROBINSON, JENNIFER BLEVINS (MS, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BLEVINS
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16155
Mailing Address - Street 2:316 BLEVINS BLVD.
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24209-6155
Mailing Address - Country:US
Mailing Address - Phone:276-669-6529
Mailing Address - Fax:
Practice Address - Street 1:204 DOGWOOD AVE.
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER (126)
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001091231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist