Healthcare Provider Details

I. General information

NPI: 1679950182
Provider Name (Legal Business Name): CIERA ROBERTS MSN, APN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 03/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11126 KINGSTON PIKE
KNOXVILLE TN
37934-2806
US

IV. Provider business mailing address

11126 KINGSTON PIKE
KNOXVILLE TN
37934-2806
US

V. Phone/Fax

Practice location:
  • Phone: 865-777-0088
  • Fax: 865-777-2015
Mailing address:
  • Phone: 865-777-0088
  • Fax: 865-777-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number17949
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: