Healthcare Provider Details

I. General information

NPI: 1073422002
Provider Name (Legal Business Name): MEGHAN MADDEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NOT APPLICABLE
NOT APPLICABLE NJ
07720
US

IV. Provider business mailing address

910 QUINCE AVE
BOULDER CO
80304-0703
US

V. Phone/Fax

Practice location:
  • Phone: 443-812-8461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ15648900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: