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NPI Code Detail

MEDICARE: MS. ROBIN LANDES WALLIN CRNP

MEDICARE: MS. ROBIN LANDES WALLIN CRNP
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
1363L00000XNurse Practitioner0001121324VA
2363L00000XNurse Practitioner0024121324VA

General Provider Information

NPI Number : 1861554453
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROBIN LANDES WALLIN CRNP
Provider Business Mailing Address
First Line : 2101 E JEFFERSON ST
Second Line : KAISER PERMANENTE MEDICARE ENROLLMENT
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 2 E GLEBE RD
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22305-2938
Country : US
Telephone Number : 703-535-5568
Fax Number : 703-535-1583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 12/29/2011

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