SHIRLEY JEAN GRAGG (NPI# 1366973109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366973109 |
| Entity Type | Individual |
| Full Name | SHIRLEY JEAN GRAGG |
| Credential | LPN II,NREMT-B,CIC-C |
| Practice Address |
2118 Chatalet Ln Pueblo CO 81005-4625 |
| Mailing Address |
202 La Vista Rd Pueblo CO 81005-2619 |
| Practice Telephone | 7195642000 |
| Mailing Telephone | 7193346584 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146N00000X | Emergency Medical Technician, Basic | EMT 511744 | FL | Emergency Medical Service Providers |
| Y | 164W00000X | Licensed Practical Nurse | PN.0047668 | CO | Nursing Service Providers |
| Street Address |
2118 CHATALET LN |
| City | PUEBLO |
| State | CO |
| Zip Code | 81005-4625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891882957 | South Pueblo Medical Investors, LLC | Skilled Nursing Facility | 2118 Chatalet Ln, Pueblo, CO 81005-4625 | 2006-10-09 |
| 1154892206 | Dayna Ellen Ehlers | Physical Therapist | 2118 Chatalet Ln, Pueblo, CO 81005-4625 | 2018-12-16 |
| 1295125912 | Romeo Oliva Jr. | Physical Therapist | 2118 Chatalet Ln, Pueblo, CO 81005-4625 | 2015-02-02 |
| 1487095410 | Jean A Larson | Social Worker | 2118 Chatalet Ln, Pueblo, CO 81005-4625 | 2013-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225595630 | Kimberly Warfield | Specialist | 5825 W Hwy 78, Pueblo, CA 81005 | 2019-02-22 |
| 1417461823 | Yah Vision | Optometrist | 2568 Taylor Ln, Pueblo, CO 81005 | 2017-11-21 |
| 1245758168 | Jenny C Alas | Dentist | 2603 Vinewood Lane, Pueblo, CO 81005 | 2017-08-30 |
| 1801342472 | Cynthia Watson | Counselor | 2429 S. Prairie Avenue, Pueblo, CO 81005 | 2016-09-01 |
| 1598033664 | Kyle Andrew Bonds | Pharmacist | 2900 W. Northern Ave., Pueblo, CO 81005 | 2011-12-05 |
| 1346406196 | Samantha Coleman | Counselor | 2429 S Prairie Ave, Pueblo, CO 81005 | 2008-07-31 |
| 1184890915 | Hg Stringert Dds, Ms, PC | Dentist | 3955 Sandlewood Lane, Pueblo, CO 81005 | 2008-05-01 |
| 1992902423 | David Russell Baer | Dentist | 2041 Pepper Lane, Ste A, Pueblo, CO 81005 | 2007-06-28 |
| 1659443695 | Thomas Wesley Ready | Dentist | 643 So Pueblo Blvd, Pueblo, CO 81005 | 2006-11-14 |
| 1700969029 | Bradley Michael Almond | Dentist | 1221 S Pueblo Blvd, Pueblo, CO 81005 | 2006-10-23 |
| Find all providers in zip 81005 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801144514 | Andrea S Lewis | Licensed Practical Nurse | 1026 West Abriendo Avenue, Pueblo, CO 81004-1128 | 2012-08-28 |
| 1366770661 | Renee Joan Sprague | Licensed Practical Nurse | 3717 Azalea St, Pueblo, CO 81005-3004 | 2009-11-24 |
| 1750514451 | Stephanie Louise Linan | Licensed Practical Nurse | 3670 Parker Boulevard, Pueblo Medical Office, Pueblo, CO 81008 | 2009-08-27 |
| 1073710216 | Ursula Lynette Hollins | Licensed Practical Nurse | 275 W Abriendo Ave, Pueblo, CO 81004-1870 | 2007-06-29 |
| 1851906390 | Jodi Spinuzzi | Licensed Practical Nurse | 275 W Abriendo Ave, Pueblo, CO 81004-1870 | 2020-09-11 |
| 1427515220 | Tiffany Getz | Licensed Practical Nurse | 1711 E Evans Ave, Pueblo, CO 81004-3349 | 2019-02-27 |
| 1063979862 | Chrystal Moon Nystuen | Licensed Practical Nurse | 1711 E Evans Ave, Pueblo, CO 81004-3349 | 2019-02-27 |
| 1184138158 | Dana G Lieser | Licensed Practical Nurse | 2429 S Prairie Ave, Pueblo, CO 81005-2886 | 2017-11-28 |
| 1952829343 | Benjamin L Jones | Licensed Practical Nurse | 400 W 16th St, Pueblo, CO 81003-2781 | 2017-09-06 |
| 1811445083 | Eloise Olivares | Licensed Practical Nurse | 5055 Outlook Blvd, Pueblo, CO 81008-1388 | 2016-09-16 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.