Provider Demographics
NPI:1639715253
Name:ROSS, TOMMERRIA LAJUNA (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TOMMERRIA
Middle Name:LAJUNA
Last Name:ROSS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3726
Mailing Address - Country:US
Mailing Address - Phone:901-425-4300
Mailing Address - Fax:901-620-6342
Practice Address - Street 1:6236 STAGE RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3726
Practice Address - Country:US
Practice Address - Phone:901-425-4300
Practice Address - Fax:901-620-6342
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903660363LP0808X
TN27026363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health