Healthcare Provider Details

I. General information

NPI: 1972261584
Provider Name (Legal Business Name): MEAGAN POORE BURRUS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8683 E LINCOLN AVE
LONE TREE CO
80124-9811
US

IV. Provider business mailing address

8683 E LINCOLN AVE
LONE TREE CO
80124-9811
US

V. Phone/Fax

Practice location:
  • Phone: 303-952-8832
  • Fax: 720-640-0107
Mailing address:
  • Phone: 303-952-8832
  • Fax: 720-640-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61253730
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN1002239-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61253730
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: