Provider Demographics
NPI:1225465305
Name:SWANSON, CHRISTINE (APN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOULTON BAND OF MALISEET INDIANS HEALTH DEPARTMENT
Mailing Address - Street 2:3 CLOVER CIRCLE
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-6704
Mailing Address - Country:US
Mailing Address - Phone:207-532-2240
Mailing Address - Fax:207-532-2067
Practice Address - Street 1:HOULTON BAND OF MALISEET INDIANS
Practice Address - Street 2:88 BELL ROAD
Practice Address - City:LITTLETON
Practice Address - State:ME
Practice Address - Zip Code:04730-6704
Practice Address - Country:US
Practice Address - Phone:207-532-4273
Practice Address - Fax:207-532-2067
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL277.002391363LP0808X, 363LF0000X
IL209-010662363LF0000X
MECNP231506363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECNP231506OtherNURSE PRACTITIONER LIC# MAINE BOARD