MEDICARE: AMANDA MARIE SWINGLE FNP

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
1	363LF0000X	Family Nurse Practitioner	251382	AZ

General Provider Information

NPI Number	:	1356066849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE SWINGLE FNP

Provider Business Mailing Address
First Line	:	261 N ROOSEVELT AVE
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85226-2617
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	844-470-2777

Provider Business Practice Location Address
First Line	:	1121 S HIGLEY RD STE 106
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-2855
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	844-470-2777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2022
Last Update Date	:	11/08/2024

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