Provider Demographics
NPI:1528240611
Name:SWANSTON, MINERVA (RN)
Entity type:Individual
Prefix:MRS
First Name:MINERVA
Middle Name:
Last Name:SWANSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 SHUART RD
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4731
Mailing Address - Country:US
Mailing Address - Phone:845-357-3502
Mailing Address - Fax:
Practice Address - Street 1:16 GRANT ST
Practice Address - Street 2:HAVERSTRAW MIDDLE SCHOOL
Practice Address - City:HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10927-1105
Practice Address - Country:US
Practice Address - Phone:845-942-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY367732-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse