Healthcare Provider Details

I. General information

NPI: 1912815572
Provider Name (Legal Business Name): EXPLORATION KIDS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 MAIN ST
DELTA CO
81416-1816
US

IV. Provider business mailing address

457 MAIN ST
DELTA CO
81416-1816
US

V. Phone/Fax

Practice location:
  • Phone: 970-665-4744
  • Fax: 970-665-4724
Mailing address:
  • Phone: 970-665-4744
  • Fax: 970-665-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NICHOLE HARDY SWANN
Title or Position: OWNER
Credential: PSY.D
Phone: 404-819-8900