Healthcare Provider Details

I. General information

NPI: 1922165836
Provider Name (Legal Business Name): ROSEMARY A. SWANKE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/29/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-0001
US

IV. Provider business mailing address

263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON CT
06030-2212
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-3107
  • Fax: 860-679-1843
Mailing address:
  • Phone: 860-679-7503
  • Fax: 860-679-1610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number001247
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: