MEDICARE: JAYDA ROBINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AC006617	MD

General Provider Information

NPI Number	:	1639728702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYDA ROBINSON

Provider Business Mailing Address
First Line	:	10230 NEW HAMPSHIRE AVE STE 100
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1422
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10230 NEW HAMPSHIRE AVE STE 100
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1422
Country	:	US
Telephone Number	:	240-269-8972
Fax Number	:	240-690-5112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2019
Last Update Date	:	03/24/2025

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