Provider Demographics
NPI:1902451644
Name:ROBINSON, KORRY ANN
Entity type:Individual
Prefix:
First Name:KORRY
Middle Name:ANN
Last Name:ROBINSON
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 1:1256 RANGE VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2104
Mailing Address - Country:US
Mailing Address - Phone:605-786-2833
Mailing Address - Fax:
Practice Address - Street 1:1501 CENTRE ST STE 100
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57703-3004
Practice Address - Country:US
Practice Address - Phone:800-521-9604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant