Provider Demographics
NPI:1972381945
Name:SWANSON, HANNA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:MARIE
Last Name:SWANSON
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 1:2900 QUANCE RD
Mailing Address - Street 2:
Mailing Address - City:MC KEAN
Mailing Address - State:PA
Mailing Address - Zip Code:16426-2138
Mailing Address - Country:US
Mailing Address - Phone:814-490-1723
Mailing Address - Fax:
Practice Address - Street 1:991 ROUTE 19 N
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:PA
Practice Address - Zip Code:16441-9739
Practice Address - Country:US
Practice Address - Phone:814-877-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA065152363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical