Provider Demographics
NPI:1669448999
Name:ROBINSON, AILEEN (NP)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 HILLANDALE DR
Mailing Address - Street 2:ANNEX E
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3802
Mailing Address - Country:US
Mailing Address - Phone:404-446-3870
Mailing Address - Fax:404-446-3875
Practice Address - Street 1:5900 HILLANDALE DR
Practice Address - Street 2:ANNEX E
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3802
Practice Address - Country:US
Practice Address - Phone:404-446-3870
Practice Address - Fax:404-446-3875
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN036342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMR1714939OtherDEA CERTIFICATE
GAMR1714939OtherDEA CERTIFICATE
GAP92694Medicare UPIN