Provider Demographics
NPI:1467803379
Name:OWENS, ROBERT (PMHNP-BC, MSN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:OWENS
Suffix:
Gender:M
Credentials:PMHNP-BC, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4856 INNOVATION DR STE B
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5540
Mailing Address - Country:US
Mailing Address - Phone:970-494-4200
Mailing Address - Fax:
Practice Address - Street 1:2625 REDWING RD STE 110
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2878
Practice Address - Country:US
Practice Address - Phone:720-897-5722
Practice Address - Fax:727-800-2333
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1644158163W00000X
CORXN.0102485-NP363LP0808X
COAPN.0992862-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse