Healthcare Provider Details

I. General information

NPI: 1235384900
Provider Name (Legal Business Name): IVAN L ROBINSON AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2008
Last Update Date: 11/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 MICHIGAN AVE NE
WASHINGTON DC
20017-1811
US

IV. Provider business mailing address

1100 MICHIGAN AVE NE
WASHINGTON DC
20017-1811
US

V. Phone/Fax

Practice location:
  • Phone: 202-652-0536
  • Fax: 202-536-4369
Mailing address:
  • Phone: 202-652-0536
  • Fax: 202-536-4369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1010528
License Number StateDC

VIII. Authorized Official

Name: IVAN L ROBINSON
Title or Position: PROVIDOR
Credential: FNP
Phone: 202-652-0536