Individual
MR. JACOB ANDREW ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
601 E HAMPDEN AVE STE 470, ENGLEWOOD, CO 80113-2797
(303) 788-3150
Mailing address
601 E HAMPDEN AVE STE 470, ENGLEWOOD, CO 80113-2797
(303) 788-3150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9116481
FL
363A00000X
Physician Assistant
Primary
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024715-01
NEW YORK STATE LICENSE
NY
01
—
1160504
NCCPA
—
01
—
PA9116481
FLORIDAPALICENSE
FL
Enumeration date
02/14/2019
Last updated
03/20/2026
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