=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972570679
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIMBERLY SWENDSEN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2006
-----------------------------------------------------
Last Update Date | 05/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4849 WILLIAM FLYNN HWY
-----------------------------------------------------
City | ALLISON PARK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15101-2319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-443-2418
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 102 COBBLESTONE CT
-----------------------------------------------------
City | ZELIENOPLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16063-2730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-272-0472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP007384
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------