Provider Demographics
NPI:1104259324
Name:SWEITZER, DANA MICHELLE (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MICHELLE
Last Name:SWEITZER
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 FRITZ ST SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-6009
Mailing Address - Country:US
Mailing Address - Phone:423-479-4165
Mailing Address - Fax:423-478-5289
Practice Address - Street 1:1420 FRITZ ST SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323-6009
Practice Address - Country:US
Practice Address - Phone:423-479-4165
Practice Address - Fax:423-478-5289
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN232965363L00000X
TN17820363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ004376Medicaid