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NPI Code Detail

MEDICARE: JESSICA NICHOLE HARDY SWANN PSY.D

MEDICARE:   JESSICA NICHOLE  HARDY SWANN  PSY.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY.0005084CO

General Provider Information

NPI Number : 1609225440
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA NICHOLE HARDY SWANN PSY.D
Provider Business Mailing Address
First Line : 1001 GRAND AVE
Second Line : SUITE 005
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-3642
Country : US
Telephone Number : 404-819-8900
Fax Number :
Provider Business Practice Location Address
First Line : 1001 GRAND AVE
Second Line : SUITE 005
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-3642
Country : US
Telephone Number : 404-819-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2016
Last Update Date : 08/05/2020

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