MEDICARE: KRISTINA L ROBINSON CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	COA.16134-NP	OH

General Provider Information

NPI Number	:	1396144838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA L ROBINSON CNP

Provider Business Mailing Address
First Line	:	13494 RAVENNA AVE NE
Second Line	:
City	:	ALLIANCE
State	:	OH
Zip	:	44601-9736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1069 KENMORE BLVD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44314-2157
Country	:	US
Telephone Number	:	330-848-0670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	08/21/2014

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