Healthcare Provider Details

I. General information

NPI: 1245495167
Provider Name (Legal Business Name): AMY M SWADNER AT-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N SENATE BLVD #200
INDIANAPOLIS IN
46202-1228
US

IV. Provider business mailing address

1801 N SENATE BLVD #200
INDIANAPOLIS IN
46202-1228
US

V. Phone/Fax

Practice location:
  • Phone: 317-802-2000
  • Fax: 317-917-4190
Mailing address:
  • Phone: 317-802-2000
  • Fax: 317-917-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number246Z00000X
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: