Healthcare Provider Details

I. General information

NPI: 1669466033
Provider Name (Legal Business Name): ELIZABETH O SWANSON APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E PHILLIPS RD
GREER SC
29650-4815
US

IV. Provider business mailing address

2700 E PHILLIPS RD
GREER SC
29650-4815
US

V. Phone/Fax

Practice location:
  • Phone: 864-235-2335
  • Fax: 864-877-1260
Mailing address:
  • Phone: 864-235-2335
  • Fax: 864-877-1260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF930
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License NumberF930
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: