Healthcare Provider Details

I. General information

NPI: 1073767810
Provider Name (Legal Business Name): ROBIN RENEE SMITH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EMANCIPATION DR
HAMPTON VA
23667-0001
US

IV. Provider business mailing address

268 SHERBROOKE DR
NEWPORT NEWS VA
23602-7578
US

V. Phone/Fax

Practice location:
  • Phone: 757-722-9961
  • Fax: 757-728-3392
Mailing address:
  • Phone: 757-874-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0001171658
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: