Individual
DAMIAN GRADISAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
1919 W US HIGHWAY 50, PUEBLO, CO 81008-1618
(719) 253-7102
(719) 253-7114
Mailing address
1919 W US HIGHWAY 50, PUEBLO, CO 81008-1618
(719) 253-7102
(719) 253-7114
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APN0992783NP
CO
Other
Enumeration date
12/01/2016
Last updated
03/16/2017
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