Provider Demographics
NPI:1316339138
Name:ROBERTSON, TRINELL (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:TRINELL
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3931 MUNDY MILL RD
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-3431
Mailing Address - Country:US
Mailing Address - Phone:770-219-8275
Mailing Address - Fax:
Practice Address - Street 1:3931 MUNDY MILL RD STE C
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566-3431
Practice Address - Country:US
Practice Address - Phone:770-219-8275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF0215021363LF0000X
GARN199543363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health