Healthcare Provider Details

I. General information

NPI: 1124264122
Provider Name (Legal Business Name): JILL ROBINSON SPIVAK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL IRENE ROBINSON RN

II. Dates (important events)

Enumeration Date: 12/22/2008
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW 2 MAIN, TRANPSLANT SURGERY
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

14227 MASTERPIECE LN
NORTH POTOMAC MD
20878-4333
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-3700
  • Fax: 202-444-2969
Mailing address:
  • Phone: 301-251-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1005206
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: