MEDICARE: MRS. JENNIFER M ROBINSON NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN152308	GA

General Provider Information

NPI Number	:	1790072601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER M ROBINSON NP-C

Provider Business Mailing Address
First Line	:	504 WALDO ST SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-3424
Country	:	US
Telephone Number	:	404-275-2552
Fax Number	:	229-516-1440

Provider Business Practice Location Address
First Line	:	371 E PACES FERRY RD NE STE 750
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2372
Country	:	US
Telephone Number	:	770-487-3200
Fax Number	:	229-516-1440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2011
Last Update Date	:	02/08/2023

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