Provider Demographics
NPI:1043356744
Name:SWARTZ, JEAN ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ANN
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:7544 HOSPITAL DR STE 202
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4178
Practice Address - Country:US
Practice Address - Phone:804-694-5553
Practice Address - Fax:804-694-8232
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2022-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY366248163W00000X
NY302690363LA2200X
VA0024182261363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01730116Medicaid