Healthcare Provider Details

I. General information

NPI: 1497380265
Provider Name (Legal Business Name): AUDREY L SWARTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 PLEASANT ST
BRIDGEWATER MA
02324-2472
US

IV. Provider business mailing address

1029 PLEASANT ST
BRIDGEWATER MA
02324-2472
US

V. Phone/Fax

Practice location:
  • Phone: 508-697-8116
  • Fax:
Mailing address:
  • Phone: 508-697-8116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2312160
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2312160
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: