MEDICARE: MR. ROBERT WILLIAM BASTIEN PMHNP-BC

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	2084P0800X	Psychiatry Physician	202000765	OR

General Provider Information

NPI Number	:	1548895386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT WILLIAM BASTIEN PMHNP-BC

Provider Business Mailing Address
First Line	:	812 E CUCHARRAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3622
Country	:	US
Telephone Number	:	409-771-7831
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 E CUCHARRAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3622
Country	:	US
Telephone Number	:	409-771-7831
Fax Number	:

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

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	02/13/2026

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