=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073422002
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGHAN MADDEN NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2026
-----------------------------------------------------
Last Update Date | 09/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | NOT APPLICABLE
-----------------------------------------------------
City | NOT APPLICABLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-812-8461
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 910 QUINCE AVE
-----------------------------------------------------
City | BOULDER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80304-0703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ15648900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------