Provider Demographics
NPI:1407748650
Name:YOUNGBLOOD, ROBIN RENEE
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENEE
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:RENEE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2870 E GRAND BLVD STE 6685
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3129
Mailing Address - Country:US
Mailing Address - Phone:248-900-3068
Mailing Address - Fax:
Practice Address - Street 1:2870 E GRAND BLVD STE 6685
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3129
Practice Address - Country:US
Practice Address - Phone:248-900-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider