Provider Demographics
NPI:1770990103
Name:ROSCOW, BREANNA RAE (MS)
Entity type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:RAE
Last Name:ROSCOW
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:BREANNA
Other - Middle Name:RAE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4726
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-5503
Practice Address - Street 1:4715 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1385
Practice Address - Country:US
Practice Address - Phone:303-385-2000
Practice Address - Fax:303-444-1839
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS