Provider Demographics
NPI:1952479974
Name:AINSCOUGH, ROSANNE GROVER (RD)
Entity Type:Individual
Prefix:
First Name:ROSANNE
Middle Name:GROVER
Last Name:AINSCOUGH
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 1:6684 S PONTIAC CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4624
Mailing Address - Country:US
Mailing Address - Phone:720-261-7885
Mailing Address - Fax:720-598-1011
Practice Address - Street 1:6684 S PONTIAC CT
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4624
Practice Address - Country:US
Practice Address - Phone:720-261-7885
Practice Address - Fax:720-598-1011
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COR659656133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
COR659656OtherDIETITIAN REGISTRATION
CO456938Medicare ID - Type Unspecified