Healthcare Provider Details

I. General information

NPI: 1295141521
Provider Name (Legal Business Name): KOURTNEY BROOKE ROBINSON H.I.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 TIMOTHY RD SUITE B
ATHENS GA
30606
US

IV. Provider business mailing address

2080 TIMOTHY RD SUITE B
ATHENS GA
30606
US

V. Phone/Fax

Practice location:
  • Phone: 706-888-6921
  • Fax: 706-341-0036
Mailing address:
  • Phone: 706-888-6921
  • Fax: 706-341-0036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADS000924
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: