Provider Demographics
NPI:1669801106
Name:SWENSON, KATELYN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 MAIN AVE W
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-1312
Mailing Address - Country:US
Mailing Address - Phone:701-499-5525
Mailing Address - Fax:
Practice Address - Street 1:1262 MAIN AVE W
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-1312
Practice Address - Country:US
Practice Address - Phone:701-499-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND203036207Q00000X
NDR37988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse