=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942238845
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN SWARTS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2006
-----------------------------------------------------
Last Update Date | 03/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1430 E CALVADA BLVD STE 200
-----------------------------------------------------
City | PAHRUMP
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89048-5852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-505-1214
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10609 KENNEDY PEAK LN
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89166-5044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-852-2597
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 12709
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------