Provider Demographics
NPI:1013160696
Name:THALL, ROBIN (RN BSN CCM LNCC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:THALL
Suffix:
Gender:F
Credentials:RN BSN CCM LNCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4397
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-1450
Mailing Address - Country:US
Mailing Address - Phone:303-840-0713
Mailing Address - Fax:303-805-5809
Practice Address - Street 1:18695 PONY EXPRESS DRIVE # 4397
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-0713
Practice Address - Fax:303-805-5809
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68412163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management