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General NPI Number Information
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NPI Number | 1942087465
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Entity Type | Individual
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Provider Name | TAMHRA ROBERSON
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Gender | Female
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 4395 FULTON INDUSTRIAL BLVD SW STE D
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City | ATLANTA
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State | GA
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Zip | 30336-1955
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Country | US
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Telephone | 404-500-0129
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Fax | 470-729-7612
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Provider Business Mailing Address
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Address Line | 500 SAWGRASS VW
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City | FAIRBURN
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State | GA
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Zip | 30213-2884
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Country | US
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Telephone | 404-500-0129
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Fax | 470-729-7612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246QL0900X
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Taxonomy Name | Laboratory Management Specialist/Technologist
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License Number |
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Taxonomy #3
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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Taxonomy #5
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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