Provider Demographics
NPI:1023896891
Name:ROBINSON, IVAH K
Entity type:Individual
Prefix:
First Name:IVAH
Middle Name:K
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 SWEET CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-8142
Mailing Address - Country:US
Mailing Address - Phone:843-557-4921
Mailing Address - Fax:
Practice Address - Street 1:243 SWEET CHERRY LN
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-8142
Practice Address - Country:US
Practice Address - Phone:843-557-4921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide