NPI
Madeline Wallace
NPI 1649854456
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- PA-C
- Type
- Individual
- Enumeration date
- 2021-05-07
- Last updated
- 2021-06-29
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Specialties
Licenses
- License CO
- 6761
Location
- Practice location
- 2930 11th Ave
- City
- Evans CO
- Postal code
- 80620-1011
- Phone
- (970) 353-9403
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Evans, CO. 192 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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