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General NPI Number Information
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NPI Number | 1215596762
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Entity Type | Individual
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Provider Name | ROSE KNUDSEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2019
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 4747 ARAPAHOE AVE
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City | BOULDER
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State | CO
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Zip | 80303-1131
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Country | US
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Telephone | 303-415-7610
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Fax | 303-415-7618
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Provider Business Mailing Address
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Address Line | PO BOX 9049
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City | BOULDER
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State | CO
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Zip | 80301-9049
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Country | US
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Telephone | 303-415-4101
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Fax | 303-415-4769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD26110
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | EC191063
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0002955
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License Number State | CO
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