Provider Demographics
NPI:1588395081
Name:SWANSON, KAREN (CNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38363 MISTY MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:N RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-1166
Mailing Address - Country:US
Mailing Address - Phone:330-723-3833
Mailing Address - Fax:
Practice Address - Street 1:38363 MISTY MEADOW TRL
Practice Address - Street 2:
Practice Address - City:N RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-1166
Practice Address - Country:US
Practice Address - Phone:330-723-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0031333363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology