Provider Demographics
NPI:1366900193
Name:ROBERTS, MELANIE GRIFFITH (APRN, CNS)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:GRIFFITH
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:APRN, CNS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3009 BRANDING IRON CIR
Mailing Address - Street 2:
Mailing Address - City:MILLIKEN
Mailing Address - State:CO
Mailing Address - Zip Code:80543-9685
Mailing Address - Country:US
Mailing Address - Phone:970-590-5719
Mailing Address - Fax:
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9004
Practice Address - Country:US
Practice Address - Phone:970-624-2154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0076746163WC0200X
CO0002144364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine