Provider Demographics
NPI:1528366721
Name:SWIERCZ, KELLY RYAN (CRNA)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:RYAN
Last Name:SWIERCZ
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:3100 SPRING FOREST RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0705
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-3138
Practice Address - Fax:540-982-2719
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2023-06-19
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Provider Licenses
StateLicense IDTaxonomies
VA0024169207367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered