Provider Demographics
NPI:1144579921
Name:ROBERTSON, DONNA (FNP-C)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 MULBERRY RD APT 16
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-5721
Mailing Address - Country:US
Mailing Address - Phone:276-666-0500
Mailing Address - Fax:
Practice Address - Street 1:100 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-7588
Practice Address - Country:US
Practice Address - Phone:276-666-0500
Practice Address - Fax:276-666-0400
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017520363LF0000X
VA0024170361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily