Healthcare Provider Details
I. General information
NPI: 1871716902
Provider Name (Legal Business Name): KAREN MARGARET SWENOR NURSE PRACTITINER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/10/2007
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1007 HARBOR HILLS
MARQUETTE MI
49855
US
IV. Provider business mailing address
3288 MOANALUA RD
HONOLULU HI
96819-1469
US
V. Phone/Fax
- Phone: 808-432-0000
- Fax:
- Phone: 808-432-0000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0024167209 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 4704287125 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: