Provider Demographics
NPI:1982441838
Name:BEACON WOUND CARE, PC
Entity type:Organization
Organization Name:BEACON WOUND CARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:AGPCNP-BC
Authorized Official - Phone:303-981-1727
Mailing Address - Street 1:9980 SILVER MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5469
Mailing Address - Country:US
Mailing Address - Phone:303-981-1727
Mailing Address - Fax:720-378-4377
Practice Address - Street 1:9980 SILVER MAPLE RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-5469
Practice Address - Country:US
Practice Address - Phone:303-669-6372
Practice Address - Fax:720-378-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty