MEDICARE: VICKY SUE ROSENER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	57153	CO

General Provider Information

NPI Number	:	1548609266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKY SUE ROSENER RN

Provider Business Mailing Address
First Line	:	1625 LARIMER ST APT 1205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-1531
Country	:	US
Telephone Number	:	303-249-9511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 LARIMER ST APT 1205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-1531
Country	:	US
Telephone Number	:	303-249-9511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2013
Last Update Date	:	06/15/2013

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