Healthcare Provider Details

I. General information

NPI: 1801700232
Provider Name (Legal Business Name): MARIELLE PRIDDY ROBINSON SRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 UNIVERSITY DR
VIRGINIA BEACH VA
23453-8083
US

IV. Provider business mailing address

21 REFLECTION LN
HAMPTON VA
23666-2386
US

V. Phone/Fax

Practice location:
  • Phone: 804-339-6111
  • Fax:
Mailing address:
  • Phone: 804-339-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0001309052
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: