Provider Demographics
NPI:1992112379
Name:ROBINSON, MARKEITHA TISHUN (CSFA)
Entity type:Individual
Prefix:
First Name:MARKEITHA
Middle Name:TISHUN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 S HIGLEY RD
Mailing Address - Street 2:STE 114 #333
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-5438
Mailing Address - Country:US
Mailing Address - Phone:562-688-6881
Mailing Address - Fax:
Practice Address - Street 1:3317 S HIGLEY RD
Practice Address - Street 2:STE 114 #333
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-5438
Practice Address - Country:US
Practice Address - Phone:562-688-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ151910246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant