Provider Demographics
NPI:1407458813
Name:SWIFT, ANNA THERESA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:THERESA
Last Name:SWIFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 SHAFFER MILL RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-3036
Mailing Address - Country:US
Mailing Address - Phone:410-215-9825
Mailing Address - Fax:
Practice Address - Street 1:5070 SHAFFER MILL RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-3036
Practice Address - Country:US
Practice Address - Phone:410-215-9825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206821163WX0002X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk