Provider Demographics
NPI:1588425110
Name:ROBINSON, JERAH NYCOLE (DEM)
Entity type:Individual
Prefix:
First Name:JERAH
Middle Name:NYCOLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 STONEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2035
Mailing Address - Country:US
Mailing Address - Phone:702-629-0918
Mailing Address - Fax:
Practice Address - Street 1:11198 LAVANDOU DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3847
Practice Address - Country:US
Practice Address - Phone:702-629-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175M00000XOther Service ProvidersMidwife, Lay