Provider Demographics
NPI:1790367480
Name:ROBINSON, MICHONA HOLLY (FNP)
Entity Type:Individual
Prefix:
First Name:MICHONA
Middle Name:HOLLY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 N THORNTON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8394
Mailing Address - Country:US
Mailing Address - Phone:706-226-0508
Mailing Address - Fax:706-226-5889
Practice Address - Street 1:1504 N THORNTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8394
Practice Address - Country:US
Practice Address - Phone:706-226-0508
Practice Address - Fax:706-226-5889
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222288207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN222288OtherNP LICENSURE