Provider Demographics
NPI:1215474713
Name:SWAIN, DANIEL ROMNEY (PA-C, MHS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROMNEY
Last Name:SWAIN
Suffix:
Gender:M
Credentials:PA-C, MHS
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:SWAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-0529
Mailing Address - Country:US
Mailing Address - Phone:970-323-6141
Mailing Address - Fax:970-323-6117
Practice Address - Street 1:1250 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-3138
Practice Address - Country:US
Practice Address - Phone:970-874-8981
Practice Address - Fax:855-299-7586
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10086313-1206363A00000X
UT10086313-8906363A00000X
COPA.0005743363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant