Healthcare Provider Details

I. General information

NPI: 1386265064
Provider Name (Legal Business Name): CHARLENE A RAYERS FDNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 W LITTLETON BLVD STE 120
LITTLETON CO
80120-2003
US

IV. Provider business mailing address

2009 W LITTLETON BLVD STE 120
LITTLETON CO
80120-2003
US

V. Phone/Fax

Practice location:
  • Phone: 303-798-2985
  • Fax:
Mailing address:
  • Phone: 303-798-2985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-5810
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: