Provider Demographics
NPI:1356312938
Name:SWAIN, PAULA KOSANOVIC (RN)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:KOSANOVIC
Last Name:SWAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:KOSANOVIC
Other - Last Name:SWAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3450 EASTOAKS DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3809
Mailing Address - Country:US
Mailing Address - Phone:801-424-3505
Mailing Address - Fax:
Practice Address - Street 1:4460 HIGHLAND DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-3543
Practice Address - Country:US
Practice Address - Phone:801-273-6366
Practice Address - Fax:801-273-6363
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT269248-3102163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management