Healthcare Provider Details

I. General information

NPI: 1740317718
Provider Name (Legal Business Name): CHARLOTTE K ROSSIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5257 S WADSWORTH BLVD
LITTLETON CO
80123-2228
US

IV. Provider business mailing address

5257 S WADSWORTH BLVD
LITTLETON CO
80123-2228
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone: 303-338-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number43100
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: