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NPI Code Detail

MEDICARE: BROOKE SWANSON

MEDICARE: BROOKE SWANSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1396627584
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE SWANSON
Provider Business Mailing Address
First Line : 225 N WEBB RD
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-4039
Country : US
Telephone Number : 402-670-7661
Fax Number :
Provider Business Practice Location Address
First Line : 225 N WEBB RD
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-4039
Country : US
Telephone Number : 402-670-7661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2025
Last Update Date : 07/21/2025

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Directions to “ BROOKE SWANSON ” Practice Location

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