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General NPI Number Information
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NPI Number | 1487044244
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Entity Type | Individual
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Provider Name | MILICENT ROBINSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 1700 W MARKET ST
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City | BOLIVAR
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State | TN
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Zip | 38008-1653
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Country | US
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Telephone | 731-658-5772
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Fax |
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Provider Business Mailing Address
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Address Line | 58 GRADVIEW LOOP EXT
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City | SELMER
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State | TN
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Zip | 38375-4608
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Country | US
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Telephone | 615-556-1153
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19627
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License Number State | TN
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