Individual
RAE PERICHAROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
13611 E COLFAX AVE, AURORA, CO 80045-5701
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
82710
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11725249
—
CO
Enumeration date
08/30/2006
Last updated
04/01/2009
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