Provider Demographics
NPI:1871792051
Name:ROBERTSON, ADRIENNE CHANELLE (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:CHANELLE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-4404
Mailing Address - Country:US
Mailing Address - Phone:615-278-8379
Mailing Address - Fax:888-586-6657
Practice Address - Street 1:107 W LYTLE ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3607
Practice Address - Country:US
Practice Address - Phone:615-278-8379
Practice Address - Fax:888-586-6657
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN57977207Q00000X
LAMD.206930207Q00000X
MO2020043131207Q00000X
NJ25MA11039900207Q00000X
ALMD.42156207Q00000X
TXT9488207Q00000X
GA89662207Q00000X
IN01084906A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2371231Medicaid