Healthcare Provider Details

I. General information

NPI: 1497659171
Provider Name (Legal Business Name): RENE NERI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E CLEVELAND ST UNIT 100
LAFAYETTE CO
80026-2364
US

IV. Provider business mailing address

102 E CLEVELAND ST UNIT 100
LAFAYETTE CO
80026-2364
US

V. Phone/Fax

Practice location:
  • Phone: 303-868-4631
  • Fax:
Mailing address:
  • Phone: 303-868-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT0026088
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: