Provider Demographics
NPI:1265132286
Name:RAWLINS, AUSTIN GLEN
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:GLEN
Last Name:RAWLINS
Suffix:
Gender:M
Credentials:
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 543
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:GA
Mailing Address - Zip Code:30295-0543
Mailing Address - Country:US
Mailing Address - Phone:770-584-8371
Mailing Address - Fax:
Practice Address - Street 1:765 LANIER 400 PKWY # A
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2539
Practice Address - Country:US
Practice Address - Phone:770-205-1294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN283400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner