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General NPI Number Information
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NPI Number | 1740628908
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Entity Type | Organization
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Legal Business Name | INTOWN ATLANTA PSYCHIATRY
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 675 SEMINOLE AVE NE SUITE 111
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City | ATLANTA
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State | GA
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Zip | 30307-3408
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Country | US
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Telephone | 404-539-0719
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Fax |
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Provider Business Mailing Address
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Address Line | 675 SEMINOLE AVE NE SUITE 111
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City | ATLANTA
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State | GA
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Zip | 30307-3408
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Country | US
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Telephone | 404-539-0719
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH LAUREN ROBINSON
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Credential | NP
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Telephone | 404-323-1807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN158648NP
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License Number State | GA
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