Provider Demographics
NPI:1851544985
Name:GOLOBIC, ROSE ANN (RD)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ANN
Last Name:GOLOBIC
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 W WOODMEN RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2511
Mailing Address - Country:US
Mailing Address - Phone:719-660-2385
Mailing Address - Fax:719-520-5422
Practice Address - Street 1:670 W WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2511
Practice Address - Country:US
Practice Address - Phone:719-660-2385
Practice Address - Fax:719-520-5422
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal