Healthcare Provider Details

I. General information

NPI: 1477013167
Provider Name (Legal Business Name): LYNNE ROSE NADEAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNNE MICHELLE ROSENBERG

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 10/23/2026
Certification Date: 10/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax: 303-436-6328
Mailing address:
  • Phone: 303-602-2715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License NumberDR.0070690
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.70690
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0070690
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDR.0070690
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: