Provider Demographics
NPI:1942087465
Name:ROBERSON, TAMHRA
Entity Type:Individual
Prefix:
First Name:TAMHRA
Middle Name:
Last Name:ROBERSON
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 1:500 SAWGRASS VW
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-2884
Mailing Address - Country:US
Mailing Address - Phone:404-500-0129
Mailing Address - Fax:470-729-7612
Practice Address - Street 1:4395 FULTON INDUSTRIAL BLVD SW STE D
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30336-1955
Practice Address - Country:US
Practice Address - Phone:404-500-0129
Practice Address - Fax:470-729-7612
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management
No376G00000XNursing Service Related ProvidersNursing Home Administrator
No172A00000XOther Service ProvidersDriver
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide