Healthcare Provider Details

I. General information

NPI: 1871907782
Provider Name (Legal Business Name): TIA ROBINSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

IV. Provider business mailing address

PO BOX 90234
COLUMBIA SC
29290-1234
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 336-782-4815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number20821
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: