Robert Duckworth
Individual provider Active NPI Registered Nurse · Decatur, GA
NPI 1093263196 · NPPES record last updated Sep 17, 2016
Key facts
- NPI
- 1093263196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN213860 (GA)
- Practice address
- 445 Winn Way
Decatur, GA 30030-1707 - Phone
- (404) 294-3836
- NPI assigned
- Sep 17, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN213860 | GA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN213860 | GA | Yes |
Addresses
Primary practice location
445 Winn Way
Decatur, GA 30030-1707
Mailing address
445 Winn Way
Decatur, GA 30030-1707
Phone (404) 294-3836
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.