Provider Demographics
NPI:1639950330
Name:EDWARDS, MEGAN (MAC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:DEL NORTE
Mailing Address - State:CO
Mailing Address - Zip Code:81132-2237
Mailing Address - Country:US
Mailing Address - Phone:720-939-2993
Mailing Address - Fax:
Practice Address - Street 1:820 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:DEL NORTE
Practice Address - State:CO
Practice Address - Zip Code:81132-2237
Practice Address - Country:US
Practice Address - Phone:720-939-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU0002840171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist