Healthcare Provider Details

I. General information

NPI: 1437862950
Provider Name (Legal Business Name): MADELINE GRACE BATCHELDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE STE 1
COLORADO SPRINGS CO
80907-6794
US

IV. Provider business mailing address

2219 NORTHGLEN DR
COLORADO SPRINGS CO
80909-1631
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-5333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberPA.0007715
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007715
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: