Provider Demographics
NPI:1487275442
Name:OSTLIE-MADDEN, ERIN ALEEN (PA-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ALEEN
Last Name:OSTLIE-MADDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ALEEN
Other - Last Name:MADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 E 19TH AVE STE 5050
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1200
Mailing Address - Country:US
Mailing Address - Phone:720-754-2155
Mailing Address - Fax:720-754-2106
Practice Address - Street 1:1601 E 19TH AVE STE 5050
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1200
Practice Address - Country:US
Practice Address - Phone:720-754-2155
Practice Address - Fax:720-754-2106
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006995363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant