Provider Demographics
NPI:1902630833
Name:ROBINSON, LATOYA LYNN
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:LYNN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:LYNN
Other - Last Name:MCCALLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28371-0341
Mailing Address - Country:US
Mailing Address - Phone:910-733-4899
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8699
Practice Address - Country:US
Practice Address - Phone:910-733-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program