Provider Demographics
NPI:1134933252
Name:SWANSON, MARIA D
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:SWANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MITCHELLS AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:NE
Mailing Address - Zip Code:68726-5385
Mailing Address - Country:US
Mailing Address - Phone:605-840-0162
Mailing Address - Fax:
Practice Address - Street 1:504 MITCHELLS AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:NE
Practice Address - Zip Code:68726-5385
Practice Address - Country:US
Practice Address - Phone:605-840-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X, 3747P1801X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty