Healthcare Provider Details

I. General information

NPI: 1609063924
Provider Name (Legal Business Name): LEILANI FAJARDO SWIFT RN, MSN, WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEILANI SWIFT WOODSON RN, MSN, WHCNP

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 ALPINE AVE
BOULDER CO
80304-3402
US

IV. Provider business mailing address

1130 ALPINE AVE
BOULDER CO
80304-3402
US

V. Phone/Fax

Practice location:
  • Phone: 303-447-1361
  • Fax: 303-449-5473
Mailing address:
  • Phone: 303-447-1361
  • Fax: 303-449-5473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0005230NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number126642
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: