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General NPI Number Information
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NPI Number | 1376314401
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Entity Type | Individual
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Provider Name | AMY SWAN AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 275 W COCOA BEACH CSWY
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City | COCOA BEACH
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State | FL
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Zip | 32931-3529
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Country | US
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Telephone | 321-799-7777
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Fax | 321-799-1550
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Provider Business Mailing Address
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Address Line | 11030 SE 83RD TER
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City | NEWBERRY
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State | FL
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Zip | 32669-7416
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Country | US
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Telephone | 352-474-4116
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Fax | 347-851-8556
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9294106
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11030543
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 11030543
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License Number State | FL
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