Provider Demographics
NPI:1093549370
Name:ROBINSON, KATHYRN ALEEN (BA)
Entity type:Individual
Prefix:
First Name:KATHYRN
Middle Name:ALEEN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8590 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8320
Mailing Address - Country:US
Mailing Address - Phone:208-912-5471
Mailing Address - Fax:
Practice Address - Street 1:8590 WEST FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8320
Practice Address - Country:US
Practice Address - Phone:208-912-5471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator