Healthcare Provider Details

I. General information

NPI: 1801553474
Provider Name (Legal Business Name): MADELINE LOFTUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 SAWYER DR STE 300
DURANGO CO
81303-3412
US

IV. Provider business mailing address

281 SAWYER DR STE 300
DURANGO CO
81303-3412
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-5702
  • Fax: 970-375-7487
Mailing address:
  • Phone: 970-247-5702
  • Fax: 970-375-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1674402
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: