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General NPI Number Information
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NPI Number | 1760592554
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Entity Type | Individual
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Provider Name | CECILIA ROSE ROBERTS BSN MPH MSN
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 04/29/2016
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Provider Practice Location Address
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Address Line | 4810 RUSINA RD STE B
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8104
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Country | US
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Telephone | 719-358-5377
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Fax | 719-323-2705
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Provider Business Mailing Address
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Address Line | 4810 RUSINA RD STE B
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8104
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Country | US
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Telephone | 719-358-5377
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Fax | 719-323-2705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RXP100287
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 108079
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License Number State | CO
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