Provider Demographics
NPI:1063785350
Name:FALCON, RODRIC D (NP)
Entity type:Individual
Prefix:
First Name:RODRIC
Middle Name:D
Last Name:FALCON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8565 SOUTH POPLAR WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5861
Mailing Address - Country:US
Mailing Address - Phone:720-348-2827
Mailing Address - Fax:720-348-2803
Practice Address - Street 1:8835 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-7056
Practice Address - Country:US
Practice Address - Phone:720-643-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN0172889163WP0809X
CO0990268363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult