Provider Demographics
NPI:1851604466
Name:SWIM, PATRICIA R (NP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:SWIM
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 GOLD STAR HWY # 100
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-6702
Mailing Address - Country:US
Mailing Address - Phone:860-446-8858
Mailing Address - Fax:860-405-2140
Practice Address - Street 1:481 GOLD STAR HWY # 100
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-6702
Practice Address - Country:US
Practice Address - Phone:860-446-8858
Practice Address - Fax:860-405-2140
Is Sole Proprietor?:No
Enumeration Date:2010-07-24
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4403363LF0000X
RINPP37684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4403OtherADVANCED PRACTICE REGISTERED NURSE