Provider Demographics
NPI:1902666779
Name:CHURCH, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:CHURCH
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 1:7300 HANOVER GREEN DR STE 301-G
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1705
Mailing Address - Country:US
Mailing Address - Phone:804-229-3576
Mailing Address - Fax:
Practice Address - Street 1:7300 HANOVER GREEN DR STE 301-G
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1705
Practice Address - Country:US
Practice Address - Phone:804-229-3576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator