Provider Demographics
NPI:1336399872
Name:ROBERSON, PAMELA BUCKLEY (APRN, CNSPMH)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:BUCKLEY
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:APRN, CNSPMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:155 MORALLION HLS
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2769
Mailing Address - Country:US
Mailing Address - Phone:770-487-2913
Mailing Address - Fax:
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:13 TH FLOOR PES
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-3330
Practice Address - Fax:404-616-4766
Is Sole Proprietor?:No
Enumeration Date:2008-09-21
Last Update Date:2008-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN073844 CNS/PMH364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health