Basic Information
| Provider Information | |||||||||
| NPI: | 1265464879 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | MICHAELA | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 MAIDEN CHOICE LN | ||||||||
| Address2: | |||||||||
| City: | CATONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212285968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108823240 | ||||||||
| FaxNumber: | 4106615093 | ||||||||
| Practice Location | |||||||||
| Address1: | 8800 WALTHER BLVD | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212349001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108823240 | ||||||||
| FaxNumber: | 4106615093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 07/17/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0808X | R123555 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 0943ER-841177-04 | 01 | CARFIRST BCBS OF MD | OTHER | 8301159 | 01 | EVERCARE | OTHER | 84117702 | 01 | BCBS | OTHER | 84117703 | 01 | BCBS | OTHER | 0032 | 01 | CAREFIRST | OTHER | 788002200 | 05 | MD | MEDICAID | 093NSE-841177-03 | 01 | CAREFIRST BCBS OF MD | OTHER | 093NER-841177-03 | 01 | CAREFIRST BCBS OF MD | OTHER | 9676-0052 | 01 | CAREFIRST BCBS OF DC | OTHER | 960801001 | 05 | MD | MEDICAID |