Provider Demographics
NPI:1427764760
Name:GRAND JUNCTION ENDOCRINOLOGY
Entity type:Organization
Organization Name:GRAND JUNCTION ENDOCRINOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:540-493-1090
Mailing Address - Street 1:391 WIND RIVER DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-2487
Mailing Address - Country:US
Mailing Address - Phone:540-493-1090
Mailing Address - Fax:
Practice Address - Street 1:391 WIND RIVER DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-2487
Practice Address - Country:US
Practice Address - Phone:540-493-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty