Provider Demographics
NPI:1073657573
Name:CHAMPION, MAGGIE S (MSN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MAGGIE
Middle Name:S
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-4715
Mailing Address - Country:US
Mailing Address - Phone:970-215-6165
Mailing Address - Fax:
Practice Address - Street 1:4604 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-4715
Practice Address - Country:US
Practice Address - Phone:970-215-6165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO178420363LF0000X
CORXN06-275363LF0000X
COAPN.0991931-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP35599Medicare UPIN