| Doctor Name: | ROBIN ELIZABETH JENDRAZAK |
| NPI Number: | 1003271156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OPA-C |
| License Number: | 1255 |
| Business Practice Address: | 2716 Ashton Dr Wilmington, NC - 284122489 |
| Business Phone Number: | 9103323800 |
| Business Fax Number: | 9103323833 |
| Mailing Address: | 2716 Ashton Dr, WILMINGTON |
| State: | NC |
| Postal Code: | 284122489 |
| Phone Number: | 9103323800 |
| Fax Number: | 9103323833 |
| NPI Enumeration Date: | 12/16/2015 |
| NPI Last Update Date: | 12/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 1255 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |