Provider Demographics
NPI:1043558539
Name:GODWIN, ROBIN NICOLE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:NICOLE
Last Name:GODWIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 DR CALVIN JONES HWY
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3107
Mailing Address - Country:US
Mailing Address - Phone:336-207-4731
Mailing Address - Fax:
Practice Address - Street 1:620 DR CALVIN JONES HWY
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3107
Practice Address - Country:US
Practice Address - Phone:336-207-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008764363LP0808X, 363LP2300X
MDAC001101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily