Healthcare Provider Details

I. General information

NPI: 1568038073
Provider Name (Legal Business Name): MADELINE CAREY HORAN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 CHAPEL HILLS DR STE 240
COLORADO SPRINGS CO
80920-1056
US

IV. Provider business mailing address

595 CHAPEL HILLS DR STE 325
COLORADO SPRINGS CO
80920-1061
US

V. Phone/Fax

Practice location:
  • Phone: 719-364-4120
  • Fax:
Mailing address:
  • Phone: 719-364-4120
  • Fax: 719-364-4171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.0001083
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: