Individual
MARY K ROUSSET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1345 S BROADWAY, CORTEZ, CO 81321-9505
(970) 565-4400
(970) 565-9543
Mailing address
36665 ROAD P.3, MANCOS, CO 81328-8748
(970) 882-4750
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP 1692
CO
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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