MR. GREGORY CHARLES GRAHEK (NPI# 1558554188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558554188 |
| Entity Type | Individual |
| Full Name | MR. GREGORY CHARLES GRAHEK |
| Credential | NP-BC |
| Practice Address |
1925 E Orman Ave Ste A535 Pueblo CO 81004-3559 |
| Mailing Address |
314 W 16th St Pueblo CO 81003-2728 |
| Practice Telephone | 7195640450 |
| Practice Fax Number | 7195641659 |
| Mailing Telephone | 7196714629 |
| Mailing Fax Number | 7195831292 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2020-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
173720-5414 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5441 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 333409528 | 05 | |
| DEA | MG 1822685 | 01 | |
| CO | STATE RXN | RXN 08-123 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 314 W 16th St, Pueblo, CO 810032728 | 7196714629 | 7195831292 |
| Street Address |
1925 E ORMAN AVE STE A535 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-3559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548647795 | Stephanie Katherine Lucas | Internal Medicine | 1925 E Orman Ave Ste A535, Pueblo, CO 81004 | 2015-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679104244 | Nicole Bartolo | Nurse Practitioner | 2152 Gale Rd, Pueblo, CO 81006-1933 | 2020-01-31 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1518206531 | Christopher Dean Trujillo | Nurse Practitioner | 111 W Evans Ave, Pueblo, CO 81004 | 2013-02-11 |
| 1780703421 | Anna Mae Martinez | Nurse Practitioner | 416 Colorado Ave, Pueblo, CO 81004-2011 | 2007-03-27 |
| 1447319363 | Rose Wertz | Nurse Practitioner | 1925 E Orman Ave Ste A235, Pueblo, CO 81004-3556 | 2006-12-06 |
| 1992327217 | Kristina Reavis | Nurse Practitioner | 400 W 16th St, Pueblo, CO 81003-2781 | 2020-05-08 |
| 1730657636 | Marquez Family Medicine, Ltd. | Nurse Practitioner | 1910 Lake Ave, Pueblo, CO 81004-3322 | 2018-11-08 |
| 1790253128 | Amber Doss | Nurse Practitioner | 3670 Parker Blvd, Pueblo, CO 81008-2285 | 2018-11-03 |
| 1346718855 | Jamison Robert Lester | Nurse Practitioner | 400 W 16th St, Pueblo, CO 81003-2781 | 2018-11-02 |
| 1154898914 | Daniel Emilio Marquez | Nurse Practitioner | 201 Lamkin St Apt 101, Pueblo, CO 81003-3558 | 2018-10-30 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.