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CASEY RYKO JESTROVICH CNIM R. EEG T NPI 1538635982


NPI Information

NPI: 1538635982
Provider Name: CASEY RYKO JESTROVICH, CNIM, R. EEG T
Classification: Specialist/Technologist, Other - 246ZE0600X
Entity Type: Individual

Specialization: Electroneurodiagnostic

Address:
2318 HALL AVE
GRAND JUNCTION, CO
ZIP 81501
Phone: (303) 886-6641
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Casey Ryko Jestrovich, CNIM, R. EEG T is an electroneurodiagnostic specialist technologist other in Grand Junction, CO. Casey Ryko Jestrovich, CNIM, R. EEG T NPI is 1538635982. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2318 HALL AVE
GRAND JUNCTION, CO
ZIP 81501-234
Phone: (303) 886-6641

The enumeration date for this NPI number is 10/23/2018 and was last updated on 10/23/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1246ZE0600XSpecialist/Technologist, OtherElectroneurodiagnostic99-187-0511COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1VAD450M96159OTHERCOLORADOANTHEM BLUE CROSS/BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.