Individual
MR. GREGORY CHARLES GRAHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-BC
Contact information
Practice address
1619 N GREENWOOD ST STE 208, PUEBLO, CO 81003-2656
(719) 564-4336
(719) 561-8469
Mailing address
1619 N GREENWOOD ST STE 208, PUEBLO, CO 81003-2656
(719) 671-4629
(719) 561-8469
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
173720-5414
CO
363LF0000X
Family Nurse Practitioner
5441
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
333409528
—
CO
01
—
RXN 08-123
STATE RXN
CO
Enumeration date
08/27/2007
Last updated
01/07/2025
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