Provider Demographics
NPI:1396569539
Name:ROBINSON SMITH, ROSALYN
Entity type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:
Last Name:ROBINSON SMITH
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 1:61558 FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-8654
Mailing Address - Country:US
Mailing Address - Phone:985-750-0978
Mailing Address - Fax:985-241-5004
Practice Address - Street 1:61558 FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-8654
Practice Address - Country:US
Practice Address - Phone:985-241-1949
Practice Address - Fax:985-241-5004
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care