MEDICARE: KAREN DIANE ROYAL NP-C

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	363LF0000X	Family Nurse Practitioner	96796	CO

General Provider Information

NPI Number	:	1083810188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN DIANE ROYAL NP-C

Provider Business Mailing Address
First Line	:	9949 S OSWEGO ST
Second Line	:	SUITE 200
City	:	PARKER
State	:	CO
Zip	:	80134-3753
Country	:	US
Telephone Number	:	303-925-4750
Fax Number	:	303-925-4751

Provider Business Practice Location Address
First Line	:	9949 S OSWEGO ST
Second Line	:	SUITE 200
City	:	PARKER
State	:	CO
Zip	:	80134-3753
Country	:	US
Telephone Number	:	303-925-4750
Fax Number	:	303-925-4751

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	04/12/2017

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