Provider Demographics
NPI:1336117936
Name:GRISWOLD, ROSALYN MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:MARIE
Last Name:GRISWOLD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:721 UPTON DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3384
Mailing Address - Country:US
Mailing Address - Phone:719-390-1741
Mailing Address - Fax:719-390-1741
Practice Address - Street 1:7400 COCHRANE DRIVE
Practice Address - Street 2:
Practice Address - City:FT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-7173
Practice Address - Fax:719-526-7850
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO114370163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse