Basic Information
| Provider Information | |||||||||
| NPI: | 1245514710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRAHF | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | RRA,RT(R)(QM) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10800 E GEDDES AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123895 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 10700 E GEDDES AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037619190 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2011 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247100000X | 420838 | MD | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | 2471Q0001X | 420838 | NC | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Quality Management | 243U00000X | CO | Y | Technologists, Technicians & Other Technical Service Providers | Radiology Practitioner Assistant |
No ID Information.