Healthcare Provider Details

I. General information

NPI: 1457296733
Provider Name (Legal Business Name): RACHEL SWANSON MSN, APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12001 80TH AVE N
MAPLE GROVE MN
55369-4798
US

IV. Provider business mailing address

9840 KAISER AVE NE
OTSEGO MN
55362-8685
US

V. Phone/Fax

Practice location:
  • Phone: 763-575-7021
  • Fax: 763-575-7034
Mailing address:
  • Phone: 763-575-7021
  • Fax: 763-575-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: