Healthcare Provider Details

I. General information

NPI: 1922362201
Provider Name (Legal Business Name): PAUL G GARRATY NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2012
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9233 PARK MEADOWS DR
LONE TREE CO
80124-5697
US

IV. Provider business mailing address

4833 FRONT ST UNIT B-158
CASTLE ROCK CO
80104-7902
US

V. Phone/Fax

Practice location:
  • Phone: 970-549-6875
  • Fax: 949-222-2088
Mailing address:
  • Phone: 970-549-6875
  • Fax: 949-222-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number184839
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP990417
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0990417-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: