Provider Demographics
NPI:1104282276
Name:ROUNSAVILLE, HALEY NICOLE
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:NICOLE
Last Name:ROUNSAVILLE
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 1:2205 W WILDCAT RESERVE PKWY
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5496
Mailing Address - Country:US
Mailing Address - Phone:720-344-0334
Mailing Address - Fax:720-344-4348
Practice Address - Street 1:2205 W WILDCAT RESERVE PKWY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-5496
Practice Address - Country:US
Practice Address - Phone:720-344-0334
Practice Address - Fax:720-344-4348
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0023158183500000X
AZS024180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist