Provider Demographics
NPI:1083863856
Name:SWANSON, ANSLEY DAVINA RHODES
Entity Type:Individual
Prefix:MRS
First Name:ANSLEY
Middle Name:DAVINA RHODES
Last Name:SWANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 N QUINCY RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-9107
Mailing Address - Country:US
Mailing Address - Phone:209-277-5656
Mailing Address - Fax:
Practice Address - Street 1:2606 N QUINCY RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-9107
Practice Address - Country:US
Practice Address - Phone:209-277-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program