Provider Demographics
NPI:1568704492
Name:SWANSON, MARILYN JEAN (DNP FNP-C)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:JEAN
Last Name:SWANSON
Suffix:
Gender:F
Credentials:DNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1037
Mailing Address - Country:US
Mailing Address - Phone:440-461-0054
Mailing Address - Fax:
Practice Address - Street 1:1443 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2449
Practice Address - Country:US
Practice Address - Phone:440-461-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily