MEDICARE: MRS. ROBIN CHRISTINA ABBOTT PHYSICIAN ASSISTANT

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1972516219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN CHRISTINA ABBOTT PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	238 BROOKLEY AVE
Second Line	:	C/O LESLIE PIERSON
City	:	BOLLING AFB
State	:	DC
Zip	:	20032
Country	:	US
Telephone Number	:	202-404-5512
Fax Number	:	202-767-2238

Provider Business Practice Location Address
First Line	:	238 BROOKLEY AVE
Second Line	:	C/O LESLIE PIERSON
City	:	BOLLING AFB
State	:	DC
Zip	:	20032
Country	:	US
Telephone Number	:	202-404-5512
Fax Number	:	202-767-2238

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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