Provider Demographics
NPI:1487227013
Name:ROBERTS, TYEESHA G
Entity Type:Individual
Prefix:MRS
First Name:TYEESHA
Middle Name:G
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 SUNBURST LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-8103
Mailing Address - Country:US
Mailing Address - Phone:865-951-3721
Mailing Address - Fax:
Practice Address - Street 1:8617 SUNBURST LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-8103
Practice Address - Country:US
Practice Address - Phone:865-951-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula