Provider Demographics
NPI:1780772616
Name:ROBERTSON, DONNA HOBGOOD (WHNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:HOBGOOD
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 DURANT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8390
Mailing Address - Country:US
Mailing Address - Phone:919-781-2500
Mailing Address - Fax:919-781-9247
Practice Address - Street 1:11001 DURANT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8390
Practice Address - Country:US
Practice Address - Phone:919-781-2500
Practice Address - Fax:919-781-9247
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC940096363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMR0974736OtherCONTROLLED SUBSTANCE REGI
NC065198OtherLICENSED REGISTERED NURSE