Provider Demographics
NPI:1164785887
Name:SWAGMAN, ANN CAROL (RN CPNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:CAROL
Last Name:SWAGMAN
Suffix:
Gender:F
Credentials:RN CPNP
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Mailing Address - Street 1:710 KENMOOR AVE SE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:616-949-6112
Mailing Address - Fax:616-949-8530
Practice Address - Street 1:710 KENMOOR AVE SE
Practice Address - Street 2:SUITE 110
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-949-6112
Practice Address - Fax:616-949-8530
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704091401163W00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse