Provider Demographics
NPI:1285184267
Name:ROBBINS, KRISTEN JENNIFER
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JENNIFER
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 N SHERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2028
Mailing Address - Country:US
Mailing Address - Phone:812-593-5543
Mailing Address - Fax:
Practice Address - Street 1:6801 W 20TH ST
Practice Address - Street 2:UNIT 203
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-9637
Practice Address - Country:US
Practice Address - Phone:970-339-5319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist