Healthcare Provider Details

I. General information

NPI: 1376727396
Provider Name (Legal Business Name): KATHRYN MARIE SWANN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS KATHRYN MARIE ROBINSON

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S. E. BLUE PARKWAY LEE'S SUMMIT MEDICAL CENTER
LEE'S SUMMIT MO
64064
US

IV. Provider business mailing address

910 S MAIN ST
INDEPENDENCE MO
64050-4418
US

V. Phone/Fax

Practice location:
  • Phone: 816-282-5118
  • Fax:
Mailing address:
  • Phone: 816-254-8565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number104040
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: