Provider Demographics
NPI:1053876839
Name:SHAMS, TESS ROBERTSON (CRNP)
Entity type:Individual
Prefix:
First Name:TESS
Middle Name:ROBERTSON
Last Name:SHAMS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALBANY
Other - Middle Name:TESS
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:201 GOVERNORS DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5170
Mailing Address - Country:US
Mailing Address - Phone:256-520-6540
Mailing Address - Fax:
Practice Address - Street 1:201 GOVERNORS DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5170
Practice Address - Country:US
Practice Address - Phone:256-520-6540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily