Healthcare Provider Details

I. General information

NPI: 1487057758
Provider Name (Legal Business Name): GWENDOLYN FLONNERY-ROBERTS MSN, FNP-C, AAHIVS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 BARTOW ST
BRUNSWICK GA
31520-5604
US

IV. Provider business mailing address

2211 BARTOW ST
BRUNSWICK GA
31520-5604
US

V. Phone/Fax

Practice location:
  • Phone: 850-210-2473
  • Fax:
Mailing address:
  • Phone: 912-209-5444
  • Fax: 912-438-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number218975
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN218975
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: