Provider Demographics
NPI:1518582725
Name:ROBINSON, JENNIFER (STNA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 N CHAMPION AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1559
Mailing Address - Country:US
Mailing Address - Phone:614-554-0577
Mailing Address - Fax:
Practice Address - Street 1:169 N CHAMPION AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1559
Practice Address - Country:US
Practice Address - Phone:614-554-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide