Healthcare Provider Details

I. General information

NPI: 1992017669
Provider Name (Legal Business Name): BILLIE JO ROBINSON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS BILLIE JO MYERS

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 NOLAND DR
HAGERSTOWN MD
21740-7109
US

IV. Provider business mailing address

910 NOLAND DR
HAGERSTOWN MD
21740-7109
US

V. Phone/Fax

Practice location:
  • Phone: 240-291-6980
  • Fax:
Mailing address:
  • Phone: 240-291-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR181076
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: