Healthcare Provider Details

I. General information

NPI: 1205674983
Provider Name (Legal Business Name): BRENT R ROBBINS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 BERKMAR CIR
CHARLOTTESVILLE VA
22901-1464
US

IV. Provider business mailing address

13728 WILLISTOWN LN
ORANGE VA
22960-4689
US

V. Phone/Fax

Practice location:
  • Phone: 434-400-9668
  • Fax: 434-465-6018
Mailing address:
  • Phone: 409-719-8713
  • Fax: 434-465-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024190756
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: