Provider Demographics
NPI:1851049423
Name:SWANSON, KRISTI MARIE
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:MARIE
Last Name:SWANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-4518
Mailing Address - Country:US
Mailing Address - Phone:858-717-6509
Mailing Address - Fax:
Practice Address - Street 1:2100 PALMYRA RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1320
Practice Address - Country:US
Practice Address - Phone:229-888-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty