Provider Demographics
NPI:1558963454
Name:ROBINSON, JANESHIA D (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANESHIA
Middle Name:D
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JANESHIA
Other - Middle Name:D
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:104 DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29819-3124
Mailing Address - Country:US
Mailing Address - Phone:864-321-9529
Mailing Address - Fax:
Practice Address - Street 1:440 W MARTINTOWN RD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-6104
Practice Address - Country:US
Practice Address - Phone:803-265-2015
Practice Address - Fax:803-510-4996
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25930363L00000X
SC208527163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice