Healthcare Provider Details

I. General information

NPI: 1841945839
Provider Name (Legal Business Name): TIMOTHY ROBBINS FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 BOILING SPRINGS RD STE 2500
SPARTANBURG SC
29303-4214
US

IV. Provider business mailing address

1601 GREENE ST
COLUMBIA SC
29208-4001
US

V. Phone/Fax

Practice location:
  • Phone: 864-585-5433
  • Fax:
Mailing address:
  • Phone: 803-777-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26314
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: