Provider Demographics
NPI:1609457852
Name:RAY, ERIN COLLEEN (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:COLLEEN
Last Name:RAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7558 E WARREN CIR APT 6-205
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5347
Mailing Address - Country:US
Mailing Address - Phone:719-290-2925
Mailing Address - Fax:
Practice Address - Street 1:7100 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2714
Practice Address - Country:US
Practice Address - Phone:402-506-9000
Practice Address - Fax:402-506-9093
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2931207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty