Provider Demographics
NPI:1538686977
Name:SWAIN, DEBORAH SUZANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUZANNE
Last Name:SWAIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 NW SOUTH SHORE RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9162
Mailing Address - Country:US
Mailing Address - Phone:305-342-9559
Mailing Address - Fax:
Practice Address - Street 1:2675 NW SOUTH SHORE RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9162
Practice Address - Country:US
Practice Address - Phone:305-342-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3042622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3042622OtherFLORIDA