Healthcare Provider Details

I. General information

NPI: 1164267126
Provider Name (Legal Business Name): DIAMOND ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 DRAKE RD
SOMERSET NJ
08873-2323
US

IV. Provider business mailing address

871 CONCORDE CIR UNIT 20302
LINTHICUM HEIGHTS MD
21090-2970
US

V. Phone/Fax

Practice location:
  • Phone: 973-902-1783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ15614100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR259488
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: