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General NPI Number Information
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NPI Number | 1316696131
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Entity Type | Individual
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Provider Name | RENEE PROSSER
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Gender | Female
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 03/20/2022
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Provider Practice Location Address
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Address Line | 13992 E MARINA DR APT 111
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City | AURORA
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State | CO
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Zip | 80014-3749
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Country | US
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Telephone | 719-217-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 5255 MEMPHIS ST UNIT 304
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City | DENVER
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State | CO
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Zip | 80239-5229
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Country | US
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Telephone | 720-810-2019
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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