Provider Demographics
NPI:1477725521
Name:GRIVETTI, TODD MICHAEL (RN)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:MICHAEL
Last Name:GRIVETTI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 S PARKER RD
Mailing Address - Street 2:STE. 400
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1623
Mailing Address - Country:US
Mailing Address - Phone:720-383-0761
Mailing Address - Fax:
Practice Address - Street 1:2530 S PARKER RD
Practice Address - Street 2:STE. 400
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1623
Practice Address - Country:US
Practice Address - Phone:720-383-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO113809163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator