Provider Demographics
NPI:1144466038
Name:SWANSON, CATHERINE ANN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
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 1:6702 WHITEGATE RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1620
Mailing Address - Country:US
Mailing Address - Phone:443-310-4650
Mailing Address - Fax:410-350-3957
Practice Address - Street 1:VA MEDICAL CTR
Practice Address - Street 2:10 N GREENE ST.
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21298-0001
Practice Address - Country:US
Practice Address - Phone:443-310-4650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR147766363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology