Provider Demographics
NPI:1982916250
Name:SWAIN, JULIE L (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:SWAIN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:L
Other - Last Name:ANTONELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCNS
Mailing Address - Street 1:700 ACKERMAN RD STE 570
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1579
Mailing Address - Country:US
Mailing Address - Phone:614-293-2663
Mailing Address - Fax:614-293-2053
Practice Address - Street 1:543 TAYLOR AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1278
Practice Address - Country:US
Practice Address - Phone:614-293-2663
Practice Address - Fax:614-293-2053
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.299833163W00000X
OHAPRN.CNS.10638364S00000X
OHAPRN.CNP.12599363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0055224Medicaid