Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN206881 | GA |
N | 363LP2300X | Nurse Practitioner - Primary Care | NCO-000001 | GA |
NPI | 1033691118 |
---|---|
Provider Name | Ms. Denise Danielle Robinson |
First Address | Atlanta, GA 30342-5052 |
Second Address | Austell, GA 30106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2018 |
Last Update Date | 21/09/2018 |