Provider Demographics
NPI:1104846385
Name:ROBINSON, ELIZABETH L (APRN, BC-PMHNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:APRN, BC-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 LITTLE ST SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-1364
Mailing Address - Country:US
Mailing Address - Phone:404-539-0719
Mailing Address - Fax:404-393-9128
Practice Address - Street 1:289 LITTLE ST SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-1364
Practice Address - Country:US
Practice Address - Phone:404-539-0719
Practice Address - Fax:404-393-9128
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN158648NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA397218493CMedicaid
GAP85298Medicare UPIN
GAP00202879Medicare ID - Type UnspecifiedRR MEDICARE
GA397218493CMedicaid