Provider Demographics
NPI:1255489001
Name:SWEANY, JUDITH L (PA)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:L
Last Name:SWEANY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-797-4321
Mailing Address - Fax:989-797-4240
Practice Address - Street 1:3400 N CENTER RD STE 500
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-7922
Practice Address - Country:US
Practice Address - Phone:989-797-4321
Practice Address - Fax:989-797-4240
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIS89098363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
B45564Medicare UPIN
B43528Medicare UPIN