Provider Demographics
NPI:1083910608
Name:SWENSON, ELISABETH (RN)
Entity Type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10310 POTOMAC CORNER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3949
Mailing Address - Country:US
Mailing Address - Phone:301-509-1582
Mailing Address - Fax:
Practice Address - Street 1:10310 POTOMAC CORNER DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3949
Practice Address - Country:US
Practice Address - Phone:301-509-1582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR139582163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn