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General NPI Number Information
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NPI Number | 1851187785
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Entity Type | Individual
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Provider Name | DESIREE RENEE SWANSON LPN
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Gender | Female
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 3140 ARUNDEL LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-1815
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Country | US
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Telephone | 463-320-1619
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Fax |
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Provider Business Mailing Address
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Address Line | 8427 COUNTRY MEADOWS DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46234-1883
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Country | US
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Telephone | 463-320-1619
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 27081757C
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License Number State | IN
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