Provider Demographics
NPI:1982308243
Name:ROBINSON, ALEX TAYLOR (PCA)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:TAYLOR
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PINE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2125
Mailing Address - Country:US
Mailing Address - Phone:406-360-6080
Mailing Address - Fax:
Practice Address - Street 1:427 E BITTERROOT DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833-6968
Practice Address - Country:US
Practice Address - Phone:406-360-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty