Healthcare Provider Details

I. General information

NPI: 1336399872
Provider Name (Legal Business Name): PAMELA BUCKLEY ROBERSON APRN, CNSPMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2008
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

155 MORALLION HLS
PEACHTREE CITY GA
30269-2769
US

V. Phone/Fax

Practice location:
  • Phone: 770-426-9929
  • Fax: 770-426-8293
Mailing address:
  • Phone: 678-467-6557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN073844 CNS/PMH
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: