Healthcare Provider Details

I. General information

NPI: 1649887241
Provider Name (Legal Business Name): KAREN ANN SWAIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E VAN BUREN ST
PHOENIX AZ
85006-3742
US

IV. Provider business mailing address

1800 E VAN BUREN ST
PHOENIX AZ
85006-3742
US

V. Phone/Fax

Practice location:
  • Phone: 602-251-8535
  • Fax:
Mailing address:
  • Phone: 602-251-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number248030
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: