Healthcare Provider Details

I. General information

NPI: 1124992193
Provider Name (Legal Business Name): MEGAN NICOLE BOIRE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

7268 ISSAQUAH DR
COLORADO SPRINGS CO
80923-4235
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-2750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1682615
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: