Provider Demographics
NPI:1841438272
Name:ROBINSON, LISA BRIDWELL (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BRIDWELL
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:119 AMBULANCE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3857
Mailing Address - Country:US
Mailing Address - Phone:770-836-9658
Mailing Address - Fax:770-838-8922
Practice Address - Street 1:2906 FRANKLIN PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:GA
Practice Address - Zip Code:30217-7544
Practice Address - Country:US
Practice Address - Phone:770-836-9388
Practice Address - Fax:706-675-1936
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2012-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN149710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily