Provider Demographics
NPI:1760218390
Name:GROSCOST, ALYSSA M (RN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:GROSCOST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 AMES ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80214-8522
Mailing Address - Country:US
Mailing Address - Phone:425-903-0496
Mailing Address - Fax:
Practice Address - Street 1:15192 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3906
Practice Address - Country:US
Practice Address - Phone:303-638-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1673024163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse