Provider Demographics
NPI:1285992966
Name:SWATLING, THERESA E (ANP-C)
Entity type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:E
Last Name:SWATLING
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:E
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-C
Mailing Address - Street 1:47 NEW SCOTLAND AVE
Mailing Address - Street 2:MC 44
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-5076
Mailing Address - Fax:518-262-6722
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:MC 44
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5076
Practice Address - Fax:518-262-6722
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305687-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health