MEDICARE: RACHEL SWANSON MSN, APRN, AGNP-C

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
1	390200000X	Student in an Organized Health Care Education/Training Program		MN

General Provider Information

NPI Number	:	1457296733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SWANSON MSN, APRN, AGNP-C

Provider Business Mailing Address
First Line	:	9840 KAISER AVE NE
Second Line	:
City	:	OTSEGO
State	:	MN
Zip	:	55362-8685
Country	:	US
Telephone Number	:	763-575-7021
Fax Number	:	763-575-7034

Provider Business Practice Location Address
First Line	:	12001 80TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4798
Country	:	US
Telephone Number	:	763-575-7021
Fax Number	:	763-575-7034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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