Provider Demographics
NPI:1639843683
Name:SWARTZLANDER, ANNA AUTUMN (APRN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:AUTUMN
Last Name:SWARTZLANDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4033 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-5518
Mailing Address - Country:US
Mailing Address - Phone:402-417-8186
Mailing Address - Fax:
Practice Address - Street 1:3220 W VAN DORN ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-9278
Practice Address - Country:US
Practice Address - Phone:402-471-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113679363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty