| Lauren Graham, | |
|
215 S Parkside Dr Ste 215, Colorado Springs, CO 80910-3131 | |
| (303) 338-4545 | |
| Not Available |
| Full Name | Lauren Graham |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 215 S Parkside Dr Ste 215, Colorado Springs, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265882914 | NPI | - | NPPES |
| 174400000X | Other | CO | KAISER PERMANENTE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 975996 (Colorado) | Primary |
| Provider Name | Colorado Permanente Medical Group Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1760599724 PECOS PAC ID: 1254238454 Enrollment ID: O20031216000640 |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren Graham, 10350 E Dakota Ave, Denver, CO 80247-1314 Ph: () - | Lauren Graham, 215 S Parkside Dr Ste 215, Colorado Springs, CO 80910-3131 Ph: (303) 338-4545 |
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