Healthcare Provider Details

I. General information

NPI: 1285657817
Provider Name (Legal Business Name): LAURA JEAN ROBBINS CNS, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 PARKEAST CIR #200
CHANTILLY VA
20151-2295
US

IV. Provider business mailing address

6141 MOUNTAIN SPRINGS LN
CLIFTON VA
20124-2340
US

V. Phone/Fax

Practice location:
  • Phone: 703-968-4000
  • Fax: 703-263-1724
Mailing address:
  • Phone: 703-988-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024166728
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: