Provider Demographics
NPI:1407738016
Name:ROBINSON, KENYATTA RENEE (APRN)
Entity type:Individual
Prefix:
First Name:KENYATTA
Middle Name:RENEE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 WOODCREEK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3117
Mailing Address - Country:US
Mailing Address - Phone:513-849-1455
Mailing Address - Fax:
Practice Address - Street 1:6730 ROOSEVELT AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5730
Practice Address - Country:US
Practice Address - Phone:513-279-8035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0039793363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health