Provider Demographics
NPI:1972201317
Name:PEREZ, READE (NP)
Entity type:Individual
Prefix:
First Name:READE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:READE
Other - Middle Name:
Other - Last Name:SELCKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8246 W BOWLES AVE BLDG 1
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3097
Mailing Address - Country:US
Mailing Address - Phone:303-800-0880
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:8246 W BOWLES AVE BLDG 1
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3097
Practice Address - Country:US
Practice Address - Phone:303-800-0880
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1658364163W00000X
COAPN.0998498363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse