1144466038 NPI number — MRS. CATHERINE ANN SWANSON CRNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144466038 NPI number — MRS. CATHERINE ANN SWANSON CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWANSON
Provider First Name:
CATHERINE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144466038
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6702 WHITEGATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21029-1620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-310-4650
Provider Business Mailing Address Fax Number:
410-350-3957

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VA MEDICAL CTR
Provider Second Line Business Practice Location Address:
10 N GREENE ST.
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21298-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-310-4650
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LG0600X , with the licence number:  R147766 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com