Healthcare Provider Details

I. General information

NPI: 1447718507
Provider Name (Legal Business Name): REBECCA ANN SWISHER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 S CRANBROOK ST
WICHITA KS
67207
US

IV. Provider business mailing address

2105 S CRANBROOK ST
WICHITA KS
67207-7786
US

V. Phone/Fax

Practice location:
  • Phone: 800-931-5883
  • Fax:
Mailing address:
  • Phone: 316-644-2373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number53-78935-012
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: