Provider Demographics
NPI:1831374875
Name:SWENN, LAURIE A (CRNA)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:SWENN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:RAMSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:11781 LEE JACKSON MEMORIAL HWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033
Mailing Address - Country:US
Mailing Address - Phone:571-777-5102
Mailing Address - Fax:703-563-6256
Practice Address - Street 1:325 SOUTH BELMONT STREET
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17405
Practice Address - Country:US
Practice Address - Phone:800-463-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN340698L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020643870001Medicaid
PA120504PNCMedicare PIN