Provider Demographics
NPI:1558609883
Name:SWAN, MICHELE A (CFNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:SWAN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7650
Mailing Address - Fax:740-283-7190
Practice Address - Street 1:1805 SINCLAIR AVE
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3327
Practice Address - Country:US
Practice Address - Phone:740-346-2766
Practice Address - Fax:740-266-4981
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0079435Medicaid
OH0079435Medicaid