Provider Demographics
NPI:1235419474
Name:RODRIGUEZ, PETER AIRTH (RN, BSN)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:AIRTH
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:ABIMAEL
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10065 E HARVARD AVE
Mailing Address - Street 2:STE400
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231
Mailing Address - Country:US
Mailing Address - Phone:303-593-0896
Mailing Address - Fax:
Practice Address - Street 1:10065 E HARVARD AVE
Practice Address - Street 2:STE400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231
Practice Address - Country:US
Practice Address - Phone:303-614-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO201028163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse