Healthcare Provider Details

I. General information

NPI: 1295014298
Provider Name (Legal Business Name): REBECCA K SWANSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982168 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2168
US

IV. Provider business mailing address

982405 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2405
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-7257
  • Fax: 402-559-6782
Mailing address:
  • Phone: 402-559-7955
  • Fax: 402-559-8666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number111410
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: