Provider Demographics
NPI:1124522073
Name:ROBINSON, CHINWE KATRISE
Entity type:Individual
Prefix:
First Name:CHINWE
Middle Name:KATRISE
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 1:1390 MOCKINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-6406
Mailing Address - Country:US
Mailing Address - Phone:843-929-6062
Mailing Address - Fax:
Practice Address - Street 1:500 N MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6439
Practice Address - Country:US
Practice Address - Phone:843-832-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42081164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse