Provider Demographics
NPI:1144346065
Name:SWISHER, STEPHENIE C (CRNP)
Entity type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:C
Last Name:SWISHER
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 1:1 NOLTE DR
Mailing Address - Street 2:P.O. BOX 1001
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7111
Mailing Address - Country:US
Mailing Address - Phone:724-548-1395
Mailing Address - Fax:724-548-1396
Practice Address - Street 1:1 NOLTE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7111
Practice Address - Country:US
Practice Address - Phone:724-548-1395
Practice Address - Fax:724-548-1396
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009468363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14097370001Medicaid