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General NPI Number Information
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NPI Number | 1699003020
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Entity Type | Individual
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Provider Name | JANET SWAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 1501 N CAMPBELL AVE 4402
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City | TUCSON
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State | AZ
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Zip | 85724-0001
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Country | US
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Telephone | 520-626-6339
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Fax |
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Provider Business Mailing Address
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Address Line | 5517 N SILVER STREAM WAY
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City | TUCSON
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State | AZ
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Zip | 85704-1771
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Country | US
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Telephone | 520-395-1735
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 4539
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License Number State | AZ
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