Provider Demographics
NPI:1699459321
Name:HUSSION-DALE, ROBIN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:HUSSION-DALE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:YOLANDA
Other - Last Name:HUSSION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1211 PALMYRA RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1935
Mailing Address - Country:US
Mailing Address - Phone:229-894-5099
Mailing Address - Fax:
Practice Address - Street 1:1211 PALMYRA RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1935
Practice Address - Country:US
Practice Address - Phone:229-894-5099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA232792363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health