Healthcare Provider Details

I. General information

NPI: 1720560345
Provider Name (Legal Business Name): ELIZABETH SWINNY APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8706 FREDERICKSBURG RD STE 102
SAN ANTONIO TX
78240-1293
US

IV. Provider business mailing address

338 E NOTTINGHAM DR
SAN ANTONIO TX
78209-3329
US

V. Phone/Fax

Practice location:
  • Phone: 210-697-9500
  • Fax:
Mailing address:
  • Phone: 210-861-0912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP138196
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: