Provider Demographics
NPI:1942026653
Name:PEREA, ABIGAIL (RN,BSN)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:PEREA
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:ABIGIAL
Other - Middle Name:
Other - Last Name:SKOMAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:7020 S CLERMONT ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2045 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5494
Practice Address - Country:US
Practice Address - Phone:303-861-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1645746163WX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX1100XNursing Service ProvidersRegistered NurseOphthalmic