Healthcare Provider Details

I. General information

NPI: 1205451416
Provider Name (Legal Business Name): ROBIN SHARYE WILLIAMS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 CHURCH ST
DECATUR GA
30030-2515
US

IV. Provider business mailing address

5304 CREST RIDGE DR
EAST POINT GA
30344-8101
US

V. Phone/Fax

Practice location:
  • Phone: 404-589-9040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN238705
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: