Provider Demographics
NPI:1962153924
Name:ROBINSON, TERESA R (DNP, APRN, PMHNP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:R
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:R
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3321 W KENNEWICK AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2968
Mailing Address - Country:US
Mailing Address - Phone:509-735-6446
Mailing Address - Fax:888-869-3385
Practice Address - Street 1:3321 W KENNEWICK AVE STE 150
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2968
Practice Address - Country:US
Practice Address - Phone:541-201-3973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61335691363LP0808X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health