Provider Demographics
NPI:1407426455
Name:SWIFT, KATIE MAE (ARNP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MAE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 5TH ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2428
Mailing Address - Country:US
Mailing Address - Phone:319-404-5577
Mailing Address - Fax:
Practice Address - Street 1:6000 UNIVERSITY AVE STE 124
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8291
Practice Address - Country:US
Practice Address - Phone:515-241-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA1625912083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5206666OtherCSA