Healthcare Provider Details

I. General information

NPI: 1689263121
Provider Name (Legal Business Name): COURTNEY SWARTZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 VIKING DR
SACRAMENTO CA
95827-2844
US

IV. Provider business mailing address

3143 MIDWAY ISLAND ST
WEST SACRAMENTO CA
95691-5899
US

V. Phone/Fax

Practice location:
  • Phone: 916-364-8395
  • Fax:
Mailing address:
  • Phone: 717-331-1047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95223297
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95023365
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95023365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: