Provider Demographics
NPI:1376727396
Name:SWANN, KATHRYN MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARIE
Last Name:SWANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:MARIE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:910 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050-4418
Mailing Address - Country:US
Mailing Address - Phone:816-254-8565
Mailing Address - Fax:
Practice Address - Street 1:2100 S. E. BLUE PARKWAY
Practice Address - Street 2:LEE'S SUMMIT MEDICAL CENTER
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064
Practice Address - Country:US
Practice Address - Phone:816-282-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104040163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine