Provider Demographics
NPI:1295764686
Name:ROBERTS, LAURA MICHELE (MS, PA-C)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MICHELE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:799 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2700
Mailing Address - Country:US
Mailing Address - Phone:650-235-0250
Mailing Address - Fax:
Practice Address - Street 1:799 E HAMPDEN AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2700
Practice Address - Country:US
Practice Address - Phone:650-235-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004229363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant