Healthcare Provider Details

I. General information

NPI: 1467803379
Provider Name (Legal Business Name): ROBERT OWENS PMHNP-BC, MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 REDWING RD STE 110
FORT COLLINS CO
80526-2878
US

IV. Provider business mailing address

4856 INNOVATION DR STE B
FORT COLLINS CO
80525-5540
US

V. Phone/Fax

Practice location:
  • Phone: 720-897-5722
  • Fax: 727-800-2333
Mailing address:
  • Phone: 970-494-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1644158
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRXN.0102485-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0992862-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: