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General NPI Number Information
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NPI Number | 1134477029
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Entity Type | Individual
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Provider Name | SHONTELL ROBBINS NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 985 TAYLOR ST SW
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City | CONYERS
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State | GA
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Zip | 30012-5357
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Country | US
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Telephone | 770-785-4345
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 RIVERSIDE PKWY P. O. BOX 897
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3339
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Country | US
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Telephone | 678-442-6884
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Fax | 770-339-4297
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN112652
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License Number State | GA
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