Healthcare Provider Details

I. General information

NPI: 1053382267
Provider Name (Legal Business Name): SUSAN ANNE ROBINSON C-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8351 CHARLOTTE HWY STE 200
INDIAN LAND SC
29707-6553
US

IV. Provider business mailing address

1025 W MEETING ST STE 200
LANCASTER SC
29720-2246
US

V. Phone/Fax

Practice location:
  • Phone: 803-285-7414
  • Fax: 803-283-4329
Mailing address:
  • Phone: 803-285-7414
  • Fax: 803-283-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-05484
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17139457
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number23913
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: