Provider Demographics
NPI:1003885906
Name:ROUSSEAU, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:ROUSSEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23968 E HINSDALE PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5235
Mailing Address - Country:US
Mailing Address - Phone:303-866-9712
Mailing Address - Fax:303-766-8374
Practice Address - Street 1:23968 E HINSDALE PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5235
Practice Address - Country:US
Practice Address - Phone:303-866-9712
Practice Address - Fax:303-766-8374
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9164157163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
E3981WMedicare ID - Type Unspecified