Provider Demographics
NPI:1316520398
Name:ALLIGOOD, ROBIN LYNELLE (NP-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNELLE
Last Name:ALLIGOOD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:GA
Mailing Address - Zip Code:31790-2441
Mailing Address - Country:US
Mailing Address - Phone:229-322-9677
Mailing Address - Fax:
Practice Address - Street 1:532 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:GA
Practice Address - Zip Code:31790-2441
Practice Address - Country:US
Practice Address - Phone:229-322-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily