Individual
LISA DIANE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
85 REVETT DR, BRECKENRIDGE, CO 80424-8956
(239) 258-8191
Mailing address
85 REVETT DR, BRECKENRIDGE, CO 80424-8956
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10008992
OR
363LF0000X
Family Nurse Practitioner
Primary
235386
AR
363LF0000X
Family Nurse Practitioner
Primary
C-APN.0003225-C-NP
CO
Other
Enumeration date
11/04/2021
Last updated
04/01/2026
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