Provider Demographics
NPI:1629215280
Name:SWANSON, ERIKA LYNNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:LYNNE
Last Name:SWANSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7324
Mailing Address - Country:US
Mailing Address - Phone:781-848-1555
Mailing Address - Fax:781-848-2312
Practice Address - Street 1:382 GROVE ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7324
Practice Address - Country:US
Practice Address - Phone:781-848-1555
Practice Address - Fax:781-848-2312
Is Sole Proprietor?:No
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1569363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant