Basic Information
| Provider Information | |||||||||
| NPI: | 1841702974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCEWEN | ||||||||
| FirstName: | NADINE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2135 SOUTHGATE RD | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809062605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196334114 | ||||||||
| FaxNumber: | 7195780857 | ||||||||
| Practice Location | |||||||||
| Address1: | 2960 N CIRCLE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809091163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196348891 | ||||||||
| FaxNumber: | 7196341897 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2017 | ||||||||
| LastUpdateDate: | 10/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN0125566 | CO | N | Nursing Service Providers | Registered Nurse | 363LF0000X | APN.0992767-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.