Healthcare Provider Details

I. General information

NPI: 1275467300
Provider Name (Legal Business Name): TASHA ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 W WASHINGTON CENTER RD
FORT WAYNE IN
46825-4142
US

IV. Provider business mailing address

826 MANCK DR
FORT WAYNE IN
46814-8986
US

V. Phone/Fax

Practice location:
  • Phone: 260-424-4908
  • Fax:
Mailing address:
  • Phone: 260-424-4908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: