Provider Demographics
NPI:1679950182
Name:ROBERTS, CIERA (MSN, APN, WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CIERA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MSN, APN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11126 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2806
Mailing Address - Country:US
Mailing Address - Phone:865-777-0088
Mailing Address - Fax:865-777-0088
Practice Address - Street 1:11126 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2806
Practice Address - Country:US
Practice Address - Phone:865-777-0088
Practice Address - Fax:865-777-2015
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17949363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ013621Medicaid