Provider Demographics
NPI:1154193191
Name:SWANSON, MELISSA ANN (ANP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:SWANSON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15774 E 107TH PL
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-8724
Mailing Address - Country:US
Mailing Address - Phone:720-354-0036
Mailing Address - Fax:
Practice Address - Street 1:1601 E 19TH AVE STE 4200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1286
Practice Address - Country:US
Practice Address - Phone:303-861-4914
Practice Address - Fax:303-861-8615
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1641888163W00000X
COAPRN.0999182-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse