Provider Demographics
NPI:1215713474
Name:ROBISON, JAMIE AHN (AS, BS)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:AHN
Last Name:ROBISON
Suffix:
Gender:F
Credentials:AS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4616 SAM BRATTON AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5333
Mailing Address - Country:US
Mailing Address - Phone:505-514-8098
Mailing Address - Fax:
Practice Address - Street 1:1960 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1828
Practice Address - Country:US
Practice Address - Phone:513-751-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1626225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant