Healthcare Provider Details

I. General information

NPI: 1083505499
Provider Name (Legal Business Name): MADISON DUFFY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7588 HARLAN ST
ARVADA CO
80003-2934
US

IV. Provider business mailing address

7588 HARLAN ST
ARVADA CO
80003-2934
US

V. Phone/Fax

Practice location:
  • Phone: 603-491-0228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1658957
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberRN.1658957
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: