Healthcare Provider Details

I. General information

NPI: 1568976975
Provider Name (Legal Business Name): NATALIE SWART CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 CORRALES RD STE 105
CORRALES NM
87048-9347
US

IV. Provider business mailing address

3949 CORRALES RD STE 105
CORRALES NM
87048-9347
US

V. Phone/Fax

Practice location:
  • Phone: 505-600-1050
  • Fax:
Mailing address:
  • Phone: 505-600-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number240651
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: