Provider Demographics
NPI:1063016723
Name:HANDLEY, ROBERT R JR (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:HANDLEY
Suffix:JR
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-1756
Mailing Address - Country:US
Mailing Address - Phone:719-346-5239
Mailing Address - Fax:
Practice Address - Street 1:110 A AVE
Practice Address - Street 2:
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80828-5051
Practice Address - Country:US
Practice Address - Phone:719-775-2256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995877-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily