Provider Demographics
NPI:1629129390
Name:ROBINSON, ANNETTE SIRMANS (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:SIRMANS
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 0070
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-0070
Mailing Address - Country:US
Mailing Address - Phone:229-433-7350
Mailing Address - Fax:229-249-6301
Practice Address - Street 1:520 GRIFFIN AVE
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-6331
Practice Address - Country:US
Practice Address - Phone:229-433-7350
Practice Address - Fax:229-242-1870
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN081735363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000901447DMedicaid