Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A49422 | CA |
N | 111NI0900X | Internist | A49422 | CA |
N | 207RR0500X | Rheumatology | 0101256642 | VA |
N | 207RR0500X | Rheumatology | 53945 | TN |
Y | 207RR0500X | Rheumatology | A49422 | CA |
NPI | 1104824366 |
---|---|
Provider Name | Dr. Tracey Robinson |
First Address | Harrisonburg, VA 22803-1430 |
Second Address | Harrisonburg, VA 22801-8679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101256642 | LICENSE (01) | VA |
BR3219753 | DEA (01) | VA |