Healthcare Provider Details

I. General information

NPI: 1003550005
Provider Name (Legal Business Name): MARIAH MEEKS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 E 19TH AVE
DENVER CO
80218-1235
US

IV. Provider business mailing address

1180 BLUE SAGE DR
STEAMBOAT SPRINGS CO
80487-3014
US

V. Phone/Fax

Practice location:
  • Phone: 720-754-6000
  • Fax:
Mailing address:
  • Phone: 651-341-2916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1680262
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: