Provider Demographics
NPI:1386265064
Name:RAYERS, CHARLENE A (FDNP)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:A
Last Name:RAYERS
Suffix:
Gender:F
Credentials:FDNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 W LITTLETON BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2003
Mailing Address - Country:US
Mailing Address - Phone:303-798-2985
Mailing Address - Fax:
Practice Address - Street 1:2009 W LITTLETON BLVD STE 120
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2003
Practice Address - Country:US
Practice Address - Phone:303-798-2985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133NN1002X
COMT-5810225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education