Provider Demographics
NPI:1326490251
Name:SWANLUND, ERIC II (CRNA)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SWANLUND
Suffix:II
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 WASHBURN AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1412
Mailing Address - Country:US
Mailing Address - Phone:612-865-8284
Mailing Address - Fax:
Practice Address - Street 1:4209 XERXES AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1412
Practice Address - Country:US
Practice Address - Phone:612-865-8284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-03
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 196827-7163W00000X
WI000000000195481163W00000X
MNCRNA 1961367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse