Individual
MEGAN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4745 ARAPAHOE AVE STE 140, BOULDER, CO 80303-1082
(303) 415-4045
(303) 415-4046
Mailing address
PO BOX 9049, BOULDER, CO 80301-9049
(303) 415-4045
(303) 415-4046
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
—
MD
367A00000X
Advanced Practice Midwife
392
MN
367A00000X
Advanced Practice Midwife
Primary
RN.1672663
CO
Other
Enumeration date
06/04/2018
Last updated
07/13/2022
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