Healthcare Provider Details

I. General information

NPI: 1285150797
Provider Name (Legal Business Name): STEPHANIE JO GRIEGO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 S SHERIDAN BLVD
DENVER CO
80227-5541
US

IV. Provider business mailing address

3100 S SHERIDAN BLVD
DENVER CO
80227-5541
US

V. Phone/Fax

Practice location:
  • Phone: 303-742-3179
  • Fax:
Mailing address:
  • Phone: 303-742-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1617869
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0993305
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: