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General NPI Number Information
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NPI Number | 1528378577
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Entity Type | Individual
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Provider Name | VIVIAN ROBINSON-WOMACK NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 145 SILVERTHORN DR
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City | TYRONE
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State | GA
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Zip | 30290-1837
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Country | US
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Telephone | 404-822-6282
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Fax |
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Provider Business Mailing Address
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Address Line | 145 SILVERTHORN DR
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City | TYRONE
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State | GA
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Zip | 30290-1837
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Country | US
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Telephone | 404-822-6282
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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 | 150697
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License Number State | GA
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