Provider Demographics
NPI:1003194044
Name:ROBERTSON, TASMA GRAHAM (DNP NP-C, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TASMA
Middle Name:GRAHAM
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:DNP NP-C, PMHNP-BC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:86 LARKSON LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-7526
Mailing Address - Country:US
Mailing Address - Phone:731-694-0056
Mailing Address - Fax:731-201-5207
Practice Address - Street 1:1440 UNION SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38075-7526
Practice Address - Country:US
Practice Address - Phone:731-254-9400
Practice Address - Fax:731-254-2326
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15935363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily