Individual
NICOLE R RAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
125 RAMPART WAY, SUITE 200, DENVER, CO 80230-6406
(720) 858-7434
(720) 858-7605
Mailing address
125 RAMPART WAY, SUITE 200, DENVER, CO 80230-6406
(720) 858-7434
(720) 858-7605
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1171
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487804852
NPI
—
Enumeration date
09/23/2008
Last updated
02/03/2009
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