Provider Demographics
NPI:1124570643
Name:ROBINSON-HARRIS, SOPHIA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:
Last Name:ROBINSON-HARRIS
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 1:2892 ANTONIA PL NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-7430
Mailing Address - Country:US
Mailing Address - Phone:140-474-9974
Mailing Address - Fax:
Practice Address - Street 1:2892 ANTONIA PL NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7430
Practice Address - Country:US
Practice Address - Phone:140-474-9974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN237690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily