Healthcare Provider Details

I. General information

NPI: 1902355498
Provider Name (Legal Business Name): MARY SWANSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ALLEMANG APRN

II. Dates (important events)

Enumeration Date: 09/26/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

2401 GILLHAM RD PROVIDER ENROLLMENT
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1955
  • Fax:
Mailing address:
  • Phone: 816-701-5200
  • Fax: 816-302-9939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number1194744
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95036797
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number237601
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2016036671
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number77447
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: