Healthcare Provider Details

I. General information

NPI: 1265883938
Provider Name (Legal Business Name): LEIGH ANN SWANK FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEIGH ANN LOWE

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 E US HIGHWAY 36
URBANA OH
43078-9600
US

IV. Provider business mailing address

205 E PALMER RD
BELLEFONTAINE OH
43311-2281
US

V. Phone/Fax

Practice location:
  • Phone: 937-887-0164
  • Fax:
Mailing address:
  • Phone: 937-592-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.019424
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.019424
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: