MEDICARE: JERROL J ROBINSON FNP-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	363L00000X	Nurse Practitioner	5674P	KY
2	363LF0000X	Family Nurse Practitioner	38457	OH
3	363LF0000X	Family Nurse Practitioner	62371	WV
4	363LF0000X	Family Nurse Practitioner	5010705	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000572232	OTHER	KY	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851554406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERROL J ROBINSON FNP-BC

Provider Business Mailing Address
First Line	:	3722 BRIDGES ST
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2944
Country	:	US
Telephone Number	:	252-499-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	3722 BRIDGES ST
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2944
Country	:	US
Telephone Number	:	252-499-8450
Fax Number	:

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	10/04/2022

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