Provider Demographics
NPI:1962145839
Name:ROBINSON, TAMERA MICHELLE
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:MICHELLE
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 1:1420 N HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-5208
Mailing Address - Country:US
Mailing Address - Phone:405-425-0375
Mailing Address - Fax:
Practice Address - Street 1:1420 N HARRISON AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-5208
Practice Address - Country:US
Practice Address - Phone:405-425-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist