Healthcare Provider Details

I. General information

NPI: 1457307233
Provider Name (Legal Business Name): KAREN ANNETTE ROBERTS PA C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 EAST 104 AVENUE SUITE 115
THORNTON CO
80233
US

IV. Provider business mailing address

5757 SOUTH FLANDERS COURT
AURORA CO
80015
US

V. Phone/Fax

Practice location:
  • Phone: 300-345-2276
  • Fax: 303-252-8694
Mailing address:
  • Phone: 303-693-6867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1989
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: