Provider Demographics
NPI:1881835718
Name:ROBINSON, CORDELIA BOONE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CORDELIA
Middle Name:BOONE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:CORDELIA
Other - Middle Name:GRACE
Other - Last Name:BOONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1170 OGILVIE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4728
Mailing Address - Country:US
Mailing Address - Phone:615-294-6816
Mailing Address - Fax:
Practice Address - Street 1:1170 OGILVIE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4728
Practice Address - Country:US
Practice Address - Phone:615-294-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN202034163W00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse