Provider Demographics
NPI:1962055061
Name:ROBINSON, RENEE (FNP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 LONG BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:GREEN MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28740-6056
Mailing Address - Country:US
Mailing Address - Phone:828-208-3506
Mailing Address - Fax:
Practice Address - Street 1:104 RICE ST
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-3304
Practice Address - Country:US
Practice Address - Phone:910-817-9927
Practice Address - Fax:910-817-9845
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012036363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health