Provider Demographics
NPI:1891475844
Name:SWENSEN, ANDREA MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:SWENSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 S GENEVA RD
Mailing Address - Street 2:HP BUILDING, ROOM 116
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5999
Mailing Address - Country:US
Mailing Address - Phone:801-863-7982
Mailing Address - Fax:
Practice Address - Street 1:987 S GENEVA RD
Practice Address - Street 2:HP BUILDING, ROOM 116
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5999
Practice Address - Country:US
Practice Address - Phone:801-863-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant