Healthcare Provider Details

I. General information

NPI: 1942984810
Provider Name (Legal Business Name): DALLAS NICOLE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 ROSLYN ST UNIT 100
DENVER CO
80238-3324
US

IV. Provider business mailing address

13645 E YALE AVE UNIT A
AURORA CO
80014-2037
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-9000
  • Fax:
Mailing address:
  • Phone: 217-260-2419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: