Provider Demographics
NPI:1023252871
Name:ROBINSON-SMALLS, PRISCILLA EVETTA (RN)
Entity type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:EVETTA
Last Name:ROBINSON-SMALLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121ST COMBAT SUPPORT HOSPITAL
Mailing Address - Street 2:UNIT 15244 BOX 221
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5244
Mailing Address - Country:US
Mailing Address - Phone:315-737-5400
Mailing Address - Fax:
Practice Address - Street 1:121ST COMBAT SUPPORT HOSPITAL
Practice Address - Street 2:UNIT 15244
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5244
Practice Address - Country:US
Practice Address - Phone:315-737-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 083588163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse