Healthcare Provider Details

I. General information

NPI: 1023763059
Provider Name (Legal Business Name): OPHELIA BEATRICE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4938 MAPLECREEK DR APT B
DAYTON OH
45426-1662
US

IV. Provider business mailing address

4938 MAPLECREEK DR APT B
DAYTON OH
45426-1662
US

V. Phone/Fax

Practice location:
  • Phone: 937-271-6240
  • Fax: 937-271-6240
Mailing address:
  • Phone: 937-271-6240
  • Fax: 937-271-6240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number195159
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRU416770
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: