Provider Demographics
NPI:1841304672
Name:SWEANEY, LOU ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:LOU
Middle Name:ANN
Last Name:SWEANEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LOU
Other - Middle Name:ANN
Other - Last Name:SWEANEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:250 BEL MARIN KEYS BLVD STE B4
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-5707
Mailing Address - Country:US
Mailing Address - Phone:415-725-3853
Mailing Address - Fax:415-464-8613
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-507-2538
Practice Address - Fax:415-499-6033
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14459363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health