MEDICARE: MICHELLE ROBERTS RD

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	133V00000X	Registered Dietitian	291166	KY
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1134831910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ROBERTS RD

Provider Business Mailing Address
First Line	:	2049 KENT CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6125
Country	:	US
Telephone Number	:	859-760-9856
Fax Number	:

Provider Business Practice Location Address
First Line	:	2049 KENT CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6125
Country	:	US
Telephone Number	:	859-760-9856
Fax Number	:

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

Provider Enumeration Date	:	12/23/2022
Last Update Date	:	02/02/2026

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Directions to “ MICHELLE ROBERTS RD” Practice Location

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