Provider Demographics
NPI:1487044244
Name:ROBINSON, MILICENT (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MILICENT
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 GRADVIEW LOOP EXT
Mailing Address - Street 2:
Mailing Address - City:SELMER
Mailing Address - State:TN
Mailing Address - Zip Code:38375-4608
Mailing Address - Country:US
Mailing Address - Phone:615-556-1153
Mailing Address - Fax:
Practice Address - Street 1:1700 W MARKET ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-1653
Practice Address - Country:US
Practice Address - Phone:731-658-5772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily