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General NPI Number Information
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NPI Number | 1245962141
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Entity Type | Individual
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Provider Name | SHANNON KELSEY ROBINSON OD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 6946 FOREST AVE # 100
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City | RICHMOND
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State | VA
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Zip | 23230-1701
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Country | US
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Telephone | 804-287-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1385 STONE CREEK LN APT 201
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-7166
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Country | US
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Telephone | 717-623-7426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618003142
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License Number State | VA
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