Provider Demographics
NPI:1407394166
Name:ROBINSON, BILLISHA GEORJANNA (APRN)
Entity type:Individual
Prefix:
First Name:BILLISHA
Middle Name:GEORJANNA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:40215 HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-7813
Practice Address - Country:US
Practice Address - Phone:863-421-9705
Practice Address - Fax:863-421-9779
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP000181363L00000X, 363LF0000X
GARN305763363L00000X
FLARNP9237370363LF0000X
FLAPRN9237370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9237370OtherSTATE LICENSE
GAGAA-NP000181OtherGA APRN LICENSE
FL117543800Medicaid