Provider Demographics
NPI:1760853600
Name:JENSEN, ROBERT FACER (NP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:FACER
Last Name:JENSEN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 LAKE PLAZA DR STE 220
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3556
Mailing Address - Country:US
Mailing Address - Phone:719-292-5051
Mailing Address - Fax:719-306-0183
Practice Address - Street 1:1235 LAKE PLAZA DR STE 220
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3556
Practice Address - Country:US
Practice Address - Phone:719-292-5051
Practice Address - Fax:719-306-0183
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991980363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health