Provider Demographics
NPI:1679755623
Name:SWANK, RONALD GLENN (RNFA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:GLENN
Last Name:SWANK
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:GLENN
Other - Last Name:SWANK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA,CNOR
Mailing Address - Street 1:923 CARLIN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3901
Mailing Address - Country:US
Mailing Address - Phone:215-350-7874
Mailing Address - Fax:
Practice Address - Street 1:923 CARLIN DR
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3901
Practice Address - Country:US
Practice Address - Phone:215-350-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-02
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN503079L163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant