MEDICARE: AYANNA DALIA ROBINSON FNP-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	5018382	NC

General Provider Information

NPI Number	:	1841977741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYANNA DALIA ROBINSON FNP-C

Provider Business Mailing Address
First Line	:	600 CALVERT ST APT 208
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-4676
Country	:	US
Telephone Number	:	703-606-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	7940 WILLIAMS POND LN STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-8410
Country	:	US
Telephone Number	:	704-757-7779
Fax Number	:

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

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	07/03/2023

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