Provider Demographics
NPI:1104480136
Name:ECKLES, MADISON (NP)
Entity type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:
Last Name:ECKLES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 S DOWNING ST STE 380
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5850
Mailing Address - Country:US
Mailing Address - Phone:303-778-5797
Mailing Address - Fax:303-778-5205
Practice Address - Street 1:2535 S DOWNING ST STE 380
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5850
Practice Address - Country:US
Practice Address - Phone:303-778-5797
Practice Address - Fax:303-778-5205
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073868363L00000X
MARN2311744363L00000X
COC-APN.0102583-C-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner