MEDICARE: COLBIE ROBIN CHRISTOPHER APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	10646902-3102	UT
2	363LA2100X	Acute Care Nurse Practitioner	10646902-4405	UT
3	363L00000X	Nurse Practitioner	10646902-4405	UT

General Provider Information

NPI Number	:	1033900725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLBIE ROBIN CHRISTOPHER APRN

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3903 MEDICAL DR STE 100
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84403-2316
Country	:	US
Telephone Number	:	801-387-8900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	12/18/2025

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