Healthcare Provider Details

I. General information

NPI: 1992587596
Provider Name (Legal Business Name): TAYLOR LYNN SWEIGART PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5657 S HIMALAYA ST
CENTENNIAL CO
80015-5307
US

IV. Provider business mailing address

8998 SCENIC PINE DR
PARKER CO
80134-2791
US

V. Phone/Fax

Practice location:
  • Phone: 303-699-6200
  • Fax:
Mailing address:
  • Phone: 720-499-6354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0008170
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: