Provider Demographics
NPI:1609645944
Name:ATKINS, BOBBIE STACEY
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:STACEY
Last Name:ATKINS
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 1:143 HINES LN
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-7908
Mailing Address - Country:US
Mailing Address - Phone:229-560-2222
Mailing Address - Fax:
Practice Address - Street 1:143 HINES LN
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-7908
Practice Address - Country:US
Practice Address - Phone:229-560-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator