Healthcare Provider Details

I. General information

NPI: 1033023908
Provider Name (Legal Business Name): MISTY ROSE RUBI RPC, QBHA, CPFS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 IRMA DR APT 8-204
NORTHGLENN CO
80233-4297
US

IV. Provider business mailing address

10500 IRMA DR APT 8-204
NORTHGLENN CO
80233-4297
US

V. Phone/Fax

Practice location:
  • Phone: 720-589-1001
  • Fax:
Mailing address:
  • Phone: 720-589-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: