Healthcare Provider Details

I. General information

NPI: 1427872092
Provider Name (Legal Business Name): EMILIE PERDUE DNP APRN RXN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12760 STROH RANCH WAY STE 104
PARKER CO
80134-7505
US

IV. Provider business mailing address

12760 STROH RANCH WAY STE 104
PARKER CO
80134-7505
US

V. Phone/Fax

Practice location:
  • Phone: 720-458-5413
  • Fax: 844-579-0123
Mailing address:
  • Phone: 720-458-5413
  • Fax: 844-579-0123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number.1668560
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.101113-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRXN.0110080-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: