Provider Demographics
NPI:1457307233
Name:ROBERTS, KAREN ANNETTE (PA C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNETTE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 SOUTH FLANDERS COURT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015
Mailing Address - Country:US
Mailing Address - Phone:303-693-6867
Mailing Address - Fax:
Practice Address - Street 1:2200 EAST 104 AVENUE
Practice Address - Street 2:SUITE 115
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233
Practice Address - Country:US
Practice Address - Phone:300-345-2276
Practice Address - Fax:303-252-8694
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA1989363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant