Healthcare Provider Details

I. General information

NPI: 1326253675
Provider Name (Legal Business Name): CAROLYN JOHNSON ROBINSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 PHOENIX BLVD STE 200
ATLANTA GA
30349-5062
US

IV. Provider business mailing address

2405 MEAD CT
JONESBORO GA
30236-9209
US

V. Phone/Fax

Practice location:
  • Phone: 678-335-9010
  • Fax: 678-229-9906
Mailing address:
  • Phone: 404-606-0942
  • Fax: 404-464-0249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN151265
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN151265
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: