Healthcare Provider Details

I. General information

NPI: 1275461345
Provider Name (Legal Business Name): JESSICA MARIE GRAHAM FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 E CRESCENT PKWY STE 120
GREENWOOD VILLAGE CO
80111-2812
US

IV. Provider business mailing address

8390 E CRESCENT PKWY STE 120
GREENWOOD VILLAGE CO
80111-2812
US

V. Phone/Fax

Practice location:
  • Phone: 303-241-0000
  • Fax: 855-576-4161
Mailing address:
  • Phone: 303-241-0000
  • Fax: 855-576-4161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002063-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: