Healthcare Provider Details

I. General information

NPI: 1427873686
Provider Name (Legal Business Name): ROSELIE WOODARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6071 E WOODMEN RD STE 200
COLORADO SPRINGS CO
80923-2609
US

IV. Provider business mailing address

3300 N TRIUMPH BLVD STE 500
LEHI UT
84043-6475
US

V. Phone/Fax

Practice location:
  • Phone: 720-712-0306
  • Fax: 720-652-4702
Mailing address:
  • Phone: 801-821-2333
  • Fax: 801-901-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1000314-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: