Provider Demographics
NPI:1881636314
Name:SWENSON, FRAN A (CRNP)
Entity Type:Individual
Prefix:
First Name:FRAN
Middle Name:A
Last Name:SWENSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64075
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 FONTANA LN
Practice Address - Street 2:STE 206
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3047
Practice Address - Country:US
Practice Address - Phone:410-391-6904
Practice Address - Fax:410-686-6640
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR049381363L00000X, 363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS 186 / 0057OtherBLUECHOICE
MDLK 36 / 612600-02OtherBC / BS OF MD
P26783Medicare UPIN
MDS 186 / 0057OtherBLUECHOICE