Provider Demographics
NPI:1164450912
Name:MARCUS, SWANEE BARBARA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SWANEE
Middle Name:BARBARA
Last Name:MARCUS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 JADE AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821
Mailing Address - Country:US
Mailing Address - Phone:570-275-7831
Mailing Address - Fax:
Practice Address - Street 1:22015 5TH STREET HOLLOW RD STE 1
Practice Address - Street 2:COLUMBIA MONTOUR FAMILY HEALTH
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815
Practice Address - Country:US
Practice Address - Phone:570-387-0236
Practice Address - Fax:570-784-1942
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP000806G363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA759852OtherPBS