Grant Bracken, PA-C
Physician Assistant in Lafayette, CO. Individual provider (NPI-1).
NPI number1164042727
StatusActive
Last updated in NPPESApr 20, 2023
Details
- NPI
- 1164042727
- Entity type
- Individual (NPI-1)
- Name
- Grant Bracken
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 23, 2020
- Certification date
- Apr 20, 2023
- Last updated
- Apr 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA.0006486 | CO | Yes |
Practice location
340 Exempla Cir Ste 300Lafayette, CO 80026-3384
Phone 303-673-1390 · Fax 720-627-6407
Mailing address
340 Exempla Cir Ste 300Lafayette, CO 80026-3384
Phone 303-673-1390 · Fax 720-627-6407
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