Healthcare Provider Details

I. General information

NPI: 1780772616
Provider Name (Legal Business Name): DONNA HOBGOOD ROBERTSON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11001 DURANT RD SUITE 100
RALEIGH NC
27614-8390
US

IV. Provider business mailing address

11001 DURANT RD SUITE 100
RALEIGH NC
27614-8390
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-2500
  • Fax: 919-781-9247
Mailing address:
  • Phone: 919-781-2500
  • Fax: 919-781-9247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number940096
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: