Individual
NICHOLLE PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8217 W 20TH ST STE C, GREELEY, CO 80634-3033
(970) 775-8103
(970) 775-8103
Mailing address
8217 W 20TH ST STE C, GREELEY, CO 80634-3033
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DR.0049827
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COAAA0380
PTAN
CO
Enumeration date
07/10/2008
Last updated
03/20/2020
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