Healthcare Provider Details

I. General information

NPI: 1598751125
Provider Name (Legal Business Name): KEISHA AISHA ROBINSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL ST
BALTIMORE MD
21202-2102
US

IV. Provider business mailing address

13821 MANOR RD
BALDWIN MD
21013-9606
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9000
  • Fax:
Mailing address:
  • Phone: 410-299-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberR152138
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: