Provider Demographics
NPI:1588007785
Name:ROTHLEIN-NARON, LISA ROSE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ROSE
Last Name:ROTHLEIN-NARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ROSE
Other - Last Name:ROTHLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:191 E ORCHARD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80121-8058
Mailing Address - Country:US
Mailing Address - Phone:303-788-3100
Mailing Address - Fax:303-788-3197
Practice Address - Street 1:191 E ORCHARD RD
Practice Address - Street 2:SWEDISH FAMILY MEDICINE
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80121-8000
Practice Address - Country:US
Practice Address - Phone:303-788-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0054801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine