MEDICARE: SUSAN ANNE ROBINSON C-FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NP-05484	OH
2	363LF0000X	Family Nurse Practitioner	17139457	VA
3	363L00000X	Nurse Practitioner	23913	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	500027170	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	021475C59	OTHER	VA	VA PTAN NUMBER
2	61459601	OTHER	VA	BLACK LUNG/FECA
3	000000342755	OTHER	OH	ANTHEM
4	23913	OTHER	SC	LICENCE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053382267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN ANNE ROBINSON C-FNP

Provider Business Mailing Address
First Line	:	1025 W MEETING ST STE 200
Second Line	:
City	:	LANCASTER
State	:	SC
Zip	:	29720-2246
Country	:	US
Telephone Number	:	803-285-7414
Fax Number	:	803-283-4329

Provider Business Practice Location Address
First Line	:	8351 CHARLOTTE HWY STE 200
Second Line	:
City	:	INDIAN LAND
State	:	SC
Zip	:	29707-6553
Country	:	US
Telephone Number	:	803-285-7414
Fax Number	:	803-283-4329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	01/07/2025

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Directions to “ SUSAN ANNE ROBINSON C-FNP” Practice Location

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