MEDICARE: MISS JAZMYN RAE GRAY CPFS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	CPFS-2107	CO

General Provider Information

NPI Number	:	1487528741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JAZMYN RAE GRAY CPFS

Provider Business Mailing Address
First Line	:	18954 E 57TH PL UNIT A
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-6794
Country	:	US
Telephone Number	:	303-999-5196
Fax Number	:

Provider Business Practice Location Address
First Line	:	3050 RICHARD ALLEN CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-4965
Country	:	US
Telephone Number	:	720-724-9544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2025
Last Update Date	:	09/30/2025

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