Provider Demographics
NPI:1518731785
Name:SWENSON, KASSANDRA A
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:A
Last Name:SWENSON
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 1:1237 ZEPHYR WAY S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3000
Mailing Address - Country:US
Mailing Address - Phone:678-983-2522
Mailing Address - Fax:
Practice Address - Street 1:1237 ZEPHYR WAY S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3000
Practice Address - Country:US
Practice Address - Phone:678-983-2522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula