Provider Demographics
NPI:1699116442
Name:SWANSON, LORI JANE (ARNP)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:JANE
Last Name:SWANSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:JANE
Other - Last Name:WESSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:EAGLE FAMILY MEDICINE @ OAK RIDGE
Mailing Address - Street 2:1510 NORTH NC HWY 68
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-3450
Mailing Address - Country:US
Mailing Address - Phone:941-822-5117
Mailing Address - Fax:
Practice Address - Street 1:1510 NC HIGHWAY 68 N
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27310-9733
Practice Address - Country:US
Practice Address - Phone:941-822-5117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010919363L00000X
FL2196072363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health