Healthcare Provider Details

I. General information

NPI: 1881636314
Provider Name (Legal Business Name): FRAN A SWENSON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 FONTANA LN STE 206
BALTIMORE MD
21237-3047
US

IV. Provider business mailing address

PO BOX 64075
BALTIMORE MD
21264-4075
US

V. Phone/Fax

Practice location:
  • Phone: 410-391-6904
  • Fax: 410-686-6640
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR049381
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR049381
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR049381
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: