Individual
TIFFANY SHEA ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1311 RING RD STE 103, ELIZABETHTOWN, KY 42701-8941
(270) 986-7372
Mailing address
2412 RING RD, SUITE 200, ELIZABETHTOWN, KY 42701-7998
(270) 765-5926
(270) 763-0051
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA713
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000310563
ANTHEM BLUE CROSS
KY
01
—
P00136548
MEDICARE-RAILROAD CARRIER
KY
Enumeration date
08/24/2005
Last updated
06/22/2018
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