Provider Demographics
NPI:1023379856
Name:SWOBODA, AMY LEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:SWOBODA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LEE
Other - Last Name:MARQUITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:901 PATIENTS FIRST DR.
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090
Mailing Address - Country:US
Mailing Address - Phone:314-691-4250
Mailing Address - Fax:
Practice Address - Street 1:901 PATIENTS FIRST DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4700
Practice Address - Country:US
Practice Address - Phone:636-239-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012010982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily