Healthcare Provider Details

I. General information

NPI: 1407634595
Provider Name (Legal Business Name): KATHRYN SWINDELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E 57TH ST STE 1210
NEW YORK NY
10022-2032
US

IV. Provider business mailing address

115 E 57TH ST STE 1210
NEW YORK NY
10022-2032
US

V. Phone/Fax

Practice location:
  • Phone: 212-203-2813
  • Fax: 646-607-9061
Mailing address:
  • Phone: 212-203-2813
  • Fax: 646-607-9061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number751850-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF352639
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF352639-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: