Provider Demographics
NPI:1285159657
Name:ROBINSON, JAN MICHELLE (RN, MA)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:MICHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RN, MA
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:MICHELLE
Other - Last Name:SIBLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, MA
Mailing Address - Street 1:715 HORIZON DR STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:515 28 3/4 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-5016
Practice Address - Country:US
Practice Address - Phone:970-263-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CORN.0079286163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health