Provider Demographics
NPI:1609508688
Name:SWENSON, CHRISTINE MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:SWENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2717
Mailing Address - Country:US
Mailing Address - Phone:607-753-5073
Mailing Address - Fax:607-756-3488
Practice Address - Street 1:60 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2717
Practice Address - Country:US
Practice Address - Phone:607-753-5073
Practice Address - Fax:607-756-3488
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY459126163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health