MEDICARE: DR. MARILYN JEAN SWANSON DNP FNP-C

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	14366	OH

General Provider Information

NPI Number	:	1568704492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN JEAN SWANSON DNP FNP-C

Provider Business Mailing Address
First Line	:	5209 ASHWOOD DR
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-1037
Country	:	US
Telephone Number	:	440-461-0054
Fax Number	:

Provider Business Practice Location Address
First Line	:	1443 RICHMOND RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2449
Country	:	US
Telephone Number	:	440-461-0054
Fax Number	:

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

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	07/21/2022

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