Provider Demographics
NPI:1508942608
Name:SWAN, FAYE-SUSAN (ND)
Entity Type:Individual
Prefix:DR
First Name:FAYE-SUSAN
Middle Name:
Last Name:SWAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:FARRA
Other - Middle Name:
Other - Last Name:SWAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:2433 E ROCKY SLOPE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-9036
Mailing Address - Country:US
Mailing Address - Phone:480-759-1102
Mailing Address - Fax:
Practice Address - Street 1:2435 E SOUTHERN AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7628
Practice Address - Country:US
Practice Address - Phone:480-820-0911
Practice Address - Fax:480-345-9336
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ83-348175F00000X
WANT00000429175F00000X
98020017176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered176B00000XOther Service ProvidersMidwife