Provider Demographics
NPI:1831493485
Name:SWEPSTON, ERIN KATHLEEN (MS, FNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHLEEN
Last Name:SWEPSTON
Suffix:
Gender:F
Credentials:MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 BERGEN ST
Mailing Address - Street 2:# 217
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3340
Mailing Address - Country:US
Mailing Address - Phone:646-858-6088
Mailing Address - Fax:
Practice Address - Street 1:1080 BERGEN ST
Practice Address - Street 2:# 217
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3340
Practice Address - Country:US
Practice Address - Phone:646-858-6088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
NY689400-1163W00000X
NY340279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04393179Medicaid