Individual
ANDREA L GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1721 E 19TH AVE STE 300, DENVER, CO 80218-1258
(720) 754-4800
(720) 754-4801
Mailing address
4900 S. MONACO ST, #210, DENVER, CO 80237-3486
(720) 754-4800
(720) 754-4801
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2260
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85289221
—
CO
01
—
COAAA1569
MEDICARE
CO
Enumeration date
03/30/2006
Last updated
11/14/2023
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