MEDICARE: LONDA Y SWOBODA FNP, BSN, MSN

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	363L00000X	Nurse Practitioner	102389	MO

General Provider Information

NPI Number	:	1851567762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LONDA Y SWOBODA FNP, BSN, MSN

Provider Business Mailing Address
First Line	:	111 E 1ST ST
Second Line	:
City	:	MONTGOMERY CITY
State	:	MO
Zip	:	63361-2550
Country	:	US
Telephone Number	:	573-564-3214
Fax Number	:	573-564-3216

Provider Business Practice Location Address
First Line	:	111 E 1ST ST
Second Line	:
City	:	MONTGOMERY CITY
State	:	MO
Zip	:	63361-2550
Country	:	US
Telephone Number	:	573-564-3214
Fax Number	:	573-564-3216

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

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	05/06/2025

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