Provider Demographics
NPI:1316365554
Name:ROBINSON, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 SAVANNAH SHORES DR
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:TN
Mailing Address - Zip Code:37325-7324
Mailing Address - Country:US
Mailing Address - Phone:423-504-3674
Mailing Address - Fax:
Practice Address - Street 1:645 PAUL HUFF PKWY NW STE 105
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312
Practice Address - Country:US
Practice Address - Phone:423-790-7750
Practice Address - Fax:423-790-7659
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily