Healthcare Provider Details
I. General information
NPI: 1912682964
Provider Name (Legal Business Name): LAUREN HOPE SWANNER CRNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/19/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2877 E FOUNTAIN BLVD
COLORADO SPRINGS CO
80910-2312
US
IV. Provider business mailing address
PO BOX 746081
ATLANTA GA
30374-6081
US
V. Phone/Fax
- Phone: 719-454-6009
- Fax: 719-640-3312
- Phone: 312-733-9730
- Fax: 773-866-8014
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R207395 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | C-APN.0100949-C-NP |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: