Provider Demographics
NPI:1922159680
Name:SWARD, KRISTIE LEE (CNS)
Entity Type:Individual
Prefix:MS
First Name:KRISTIE
Middle Name:LEE
Last Name:SWARD
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 KELLOGG BLVD E STE 8200
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1420
Mailing Address - Country:US
Mailing Address - Phone:651-266-3753
Mailing Address - Fax:651-266-4443
Practice Address - Street 1:160 KELLOGG BLVD E STE 8200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1420
Practice Address - Country:US
Practice Address - Phone:651-266-3753
Practice Address - Fax:651-266-4443
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0847140364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health