Provider Demographics
NPI:1073703526
Name:ROBERTSON, NANCY ALISON (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ALISON
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MAIN ST
Mailing Address - Street 2:PO BOX 177
Mailing Address - City:MEAD
Mailing Address - State:CO
Mailing Address - Zip Code:80542
Mailing Address - Country:US
Mailing Address - Phone:303-329-0870
Mailing Address - Fax:303-394-0871
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC0109090363L00000X
CO2965363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner