Healthcare Provider Details

I. General information

NPI: 1003279647
Provider Name (Legal Business Name): JESSICA GALANT-SWAFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206-2761
US

IV. Provider business mailing address

1400 JACKSON ST
DENVER CO
80206-2761
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4461
  • Fax: 303-398-1211
Mailing address:
  • Phone: 303-388-4461
  • Fax: 303-398-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberDR.0066426
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: