Provider Demographics
NPI:1053617928
Name:ROBINSON, BROOKE TRACI
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:TRACI
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35614
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-5614
Mailing Address - Country:US
Mailing Address - Phone:907-209-9533
Mailing Address - Fax:
Practice Address - Street 1:5636 GLACIER HWY STE 100
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9508
Practice Address - Country:US
Practice Address - Phone:907-586-6838
Practice Address - Fax:907-586-8114
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator