Provider Demographics
NPI:1548025836
Name:SWANK, BRIANNA MAREE
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MAREE
Last Name:SWANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:BOTKINS
Mailing Address - State:OH
Mailing Address - Zip Code:45306-0426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:206 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOTKINS
Practice Address - State:OH
Practice Address - Zip Code:45306-7504
Practice Address - Country:US
Practice Address - Phone:419-230-4087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.472528163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health