Provider Demographics
NPI:1346224425
Name:ROSLING, ANNETTE E (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:E
Last Name:ROSLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:E
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:626 29 3/8 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5810
Mailing Address - Country:US
Mailing Address - Phone:970-201-0217
Mailing Address - Fax:
Practice Address - Street 1:2333 N 6TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2001
Practice Address - Country:US
Practice Address - Phone:970-200-1600
Practice Address - Fax:970-697-4603
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42747208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15975347Medicaid
CO15975347Medicaid
CO535038Medicare ID - Type Unspecified