Basic Information
| Provider Information | |||||||||
| NPI: | 1992286876 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | GRAHAM | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 VERDAE BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296074021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642720388 | ||||||||
| FaxNumber: | 8642139237 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 HARRISON BRIDGE RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | SIMPSONVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296807133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642720388 | ||||||||
| FaxNumber: | 8642139237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2018 | ||||||||
| LastUpdateDate: | 11/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 22143 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.