MEDICARE: PROF. JO-ANN RICHELLE ROBINSON MSN, APRN, BC

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	363LA2200X	Adult Health Nurse Practitioner	26NJ00024000	NJ

General Provider Information

NPI Number	:	1750581989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. JO-ANN RICHELLE ROBINSON MSN, APRN, BC

Provider Business Mailing Address
First Line	:	ONE NORMAL AVENUE
Second Line	:
City	:	UPPER MONTCLAIR
State	:	NJ
Zip	:	07043
Country	:	US
Telephone Number	:	973-655-4361
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 NORMAL AVE
Second Line	:
City	:	UPPER MONTCLAIR
State	:	NJ
Zip	:	07043-1624
Country	:	US
Telephone Number	:	973-655-4361
Fax Number	:

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/25/2007

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