Provider Demographics
NPI:1902093925
Name:SWANSON, NADIA M (CRNP)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:M
Last Name:SWANSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-302-6565
Mailing Address - Fax:
Practice Address - Street 1:5602 BALTIMORE NATIONAL PIKE STE 205
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1407
Practice Address - Country:US
Practice Address - Phone:917-863-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008590363LP0808X
NYF4008800363LP0808X
DCNP1026551363LP0808X
FL9468249363LP0808X
TN33160363LP0808X
VA0024170069363LP0808X
NJ26NJ00116200363LP0808X
MDR162866363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health