Provider Demographics
NPI:1750657961
Name:ROBINSON, DEENA MARIA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEENA
Middle Name:MARIA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:STE 240
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7668
Mailing Address - Country:US
Mailing Address - Phone:770-292-3045
Mailing Address - Fax:770-292-3046
Practice Address - Street 1:4150 DEPUTY BILL CANTRELL MEMORIAL RD
Practice Address - Street 2:STE 260
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:770-292-3045
Practice Address - Fax:770-292-3046
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN195029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003129492BMedicaid
GARN195029OtherNURSE PRACT. LICENSE
GARN195029OtherNURSE PRACT. LICENSE
GA20250I4776Medicare PIN