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General NPI Number Information
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NPI Number | 1558554188
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Entity Type | Individual
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Provider Name | GREGORY CHARLES GRAHEK NP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 1619 N GREENWOOD ST STE 208
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City | PUEBLO
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State | CO
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Zip | 81003-2656
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Country | US
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Telephone | 719-564-4336
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Fax | 719-561-8469
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Provider Business Mailing Address
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Address Line | 1619 N GREENWOOD ST STE 208
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City | PUEBLO
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State | CO
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Zip | 81003-2656
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Country | US
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Telephone | 719-671-4629
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Fax | 719-561-8469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5441
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 173720-5414
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License Number State | CO
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