Healthcare Provider Details

I. General information

NPI: 1346152295
Provider Name (Legal Business Name): KENECKO ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 Q ST
RICHMOND VA
23223-5149
US

IV. Provider business mailing address

2209 Q ST
RICHMOND VA
23223-5149
US

V. Phone/Fax

Practice location:
  • Phone: 804-662-0497
  • Fax:
Mailing address:
  • Phone: 804-662-0497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: