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General NPI Number Information
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NPI Number | 1023379856
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Entity Type | Individual
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Provider Name | AMY LEE SWOBODA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 901 PATIENTS FIRST DR
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City | WASHINGTON
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State | MO
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Zip | 63090-4700
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Country | US
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Telephone | 636-239-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 901 PATIENTS FIRST DR.
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City | WASHINGTON
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State | MO
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Zip | 63090
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Country | US
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Telephone | 314-691-4250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2012010982
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License Number State | MO
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