Provider Demographics
NPI:1376524009
Name:SWIFT, SUSAN M (APRN, BC, ANP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:SWIFT
Suffix:
Gender:F
Credentials:APRN, BC, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 E NEW HOPE CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-8627
Mailing Address - Country:US
Mailing Address - Phone:765-472-4030
Mailing Address - Fax:
Practice Address - Street 1:6330 CASTLEPLACE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1902
Practice Address - Country:US
Practice Address - Phone:317-570-7900
Practice Address - Fax:317-570-2290
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002027A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health