Healthcare Provider Details

I. General information

NPI: 1083394191
Provider Name (Legal Business Name): XAVIER ROBINSON (STUDENT) RN-BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LOUIS ROBINSON (STUDENT) RN-BSN

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9443 WESTCHESTER DR
SAINT LOUIS MO
63136-5135
US

IV. Provider business mailing address

9443 WESTCHESTER DR
SAINT LOUIS MO
63136-5135
US

V. Phone/Fax

Practice location:
  • Phone: 314-614-7378
  • Fax:
Mailing address:
  • Phone: 314-614-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number2023038875
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: