Provider Demographics
NPI:1326253675
Name:ROBINSON, CAROLYN JOHNSON (RN)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JOHNSON
Last Name:ROBINSON
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 MEAD CT
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-9209
Mailing Address - Country:US
Mailing Address - Phone:404-606-0942
Mailing Address - Fax:404-464-0249
Practice Address - Street 1:1901 PHOENIX BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5062
Practice Address - Country:US
Practice Address - Phone:678-335-9010
Practice Address - Fax:678-229-9906
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN151265163WP0808X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD000Medicare UPIN