Provider Demographics
NPI:1053836239
Name:FURY-SWISHER, MARIAH ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:ANN
Last Name:FURY-SWISHER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:A
Other - Last Name:FURY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:213 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LA PORTE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50651-1235
Mailing Address - Country:US
Mailing Address - Phone:319-505-5602
Mailing Address - Fax:
Practice Address - Street 1:213 MAIN ST
Practice Address - Street 2:
Practice Address - City:LA PORTE CITY
Practice Address - State:IA
Practice Address - Zip Code:50651-1235
Practice Address - Country:US
Practice Address - Phone:319-505-5602
Practice Address - Fax:319-575-6100
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA137147163W00000X
IAG137147363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse