Provider Demographics
NPI:1841697711
Name:ROBINSON, JENELLE VONETTA (MD)
Entity type:Individual
Prefix:
First Name:JENELLE
Middle Name:VONETTA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-5416
Mailing Address - Country:US
Mailing Address - Phone:478-453-8100
Mailing Address - Fax:478-453-4475
Practice Address - Street 1:1001 FERNWOOD DR
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-5416
Practice Address - Country:US
Practice Address - Phone:478-453-8100
Practice Address - Fax:478-453-4475
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA89667207V00000X
NY390200000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology