Provider Demographics
NPI:1306818372
Name:SWENSON, JOANNE M (NP)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:M
Last Name:SWENSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WASHINGTON GRN
Mailing Address - Street 2:
Mailing Address - City:E WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02032-1164
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-769-5347
Practice Address - Fax:781-769-1049
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA127965363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP17473Medicare UPIN
MANP2850Medicare ID - Type Unspecified