Provider Demographics
NPI:1841219516
Name:GRAFF LOGAN, NOELLE GARCIA (CNM)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:GARCIA
Last Name:GRAFF LOGAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-873-5245
Mailing Address - Fax:303-873-5240
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:#225
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4514
Practice Address - Country:US
Practice Address - Phone:303-873-5245
Practice Address - Fax:303-873-5240
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2070176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07105034Medicaid
CO811063Medicare PIN
CO261197YLQFMedicare PIN
COC810263Medicare PIN