Healthcare Provider Details

I. General information

NPI: 1043824493
Provider Name (Legal Business Name): AMANDA SWANGIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 01/25/2023
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 N WALNUT ST
NORTH MANCHESTER IN
46962-1857
US

IV. Provider business mailing address

333 N SUMMIT ST
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 260-982-1994
  • Fax: 260-479-2996
Mailing address:
  • Phone: 800-427-1902
  • Fax: 800-564-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202000191967
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: