Provider Demographics
NPI:1730978529
Name:SWENSRUD, JADEN LEE (RN)
Entity type:Individual
Prefix:
First Name:JADEN
Middle Name:LEE
Last Name:SWENSRUD
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 LUCILLE CT
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-3574
Mailing Address - Country:US
Mailing Address - Phone:303-818-8003
Mailing Address - Fax:
Practice Address - Street 1:1325 LUCILLE CT
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-3574
Practice Address - Country:US
Practice Address - Phone:303-818-8003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0196444163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse