Healthcare Provider Details

I. General information

NPI: 1427969278
Provider Name (Legal Business Name): JODI K ROBERTS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 S FORK DR
SEVIERVILLE TN
37862-2966
US

IV. Provider business mailing address

1111 S FORK DR
SEVIERVILLE TN
37862-2966
US

V. Phone/Fax

Practice location:
  • Phone: 859-806-6043
  • Fax:
Mailing address:
  • Phone: 859-806-6043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number42998
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: