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NPI Code Detail

MEDICARE: KENNETH SWANSON NP

MEDICARE: KENNETH SWANSON NP
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
1363LF0000XFamily Nurse Practitioner0024000007VA

General Provider Information

NPI Number : 1659350544
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH SWANSON NP
Provider Business Mailing Address
First Line : 925 VILLAGE HWY
Second Line :
City : RUSTBURG
State : VA
Zip : 24588-4591
Country : US
Telephone Number : 434-332-7367
Fax Number : 434-332-1757
Provider Business Practice Location Address
First Line : 925 VILLAGE HWY
Second Line :
City : RUSTBURG
State : VA
Zip : 24588-4591
Country : US
Telephone Number : 434-332-7367
Fax Number : 434-332-1757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 08/14/2013

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Directions to “ KENNETH SWANSON NP” Practice Location

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