Healthcare Provider Details

I. General information

NPI: 1811658289
Provider Name (Legal Business Name): RENUE U MEDSPA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5390 N ACADEMY BLVD STE 150
COLORADO SPRINGS CO
80918-4064
US

IV. Provider business mailing address

6825 S GALENA ST STE 200
CENTENNIAL CO
80112-3630
US

V. Phone/Fax

Practice location:
  • Phone: 303-741-0990
  • Fax: 303-741-0990
Mailing address:
  • Phone: 720-741-0990
  • Fax: 303-741-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCA RAYOS
Title or Position: BILLING MANAGER
Credential:
Phone: 303-741-0990