Healthcare Provider Details

I. General information

NPI: 1346954591
Provider Name (Legal Business Name): ASJANA SWAIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 COQUINA BAY DR
SAINT PETERSBURG FL
33705-6444
US

IV. Provider business mailing address

PO BOX 14063
SAINT PETERSBURG FL
33733-4063
US

V. Phone/Fax

Practice location:
  • Phone: 727-342-0324
  • Fax:
Mailing address:
  • Phone: 727-342-0324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11023332
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: