Provider Demographics
NPI:1578702569
Name:GRADY, PATRICK ALAN (FNP)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:ALAN
Last Name:GRADY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-584-8900
Mailing Address - Fax:303-584-0525
Practice Address - Street 1:850 E HARVARD AVE STE 405
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5077
Practice Address - Country:US
Practice Address - Phone:303-584-8900
Practice Address - Fax:303-584-0525
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS958096133V00000X
CO0995701363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered