Healthcare Provider Details

I. General information

NPI: 1235210154
Provider Name (Legal Business Name): STACY ELIZABETH ROBINSON-JONES R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. STACY ELIZABETH ROBINSON

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1278 OAK KNOLL CT
LITHONIA GA
30058-3091
US

IV. Provider business mailing address

1278 OAK KNOLL CT
LITHONIA GA
30058-3091
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax: 404-728-4828
Mailing address:
  • Phone: 770-482-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN136948
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: