Provider Demographics
NPI:1952061970
Name:SWAN, JAMIE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SWAN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:BEAUMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:1699 HIGHWAY 137
Mailing Address - Street 2:
Mailing Address - City:ALBIA
Mailing Address - State:IA
Mailing Address - Zip Code:52531-8908
Mailing Address - Country:US
Mailing Address - Phone:641-895-0901
Mailing Address - Fax:
Practice Address - Street 1:1699 HIGHWAY 137
Practice Address - Street 2:
Practice Address - City:ALBIA
Practice Address - State:IA
Practice Address - Zip Code:52531-8908
Practice Address - Country:US
Practice Address - Phone:641-895-0901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113804163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management