Provider Demographics
NPI:1730595018
Name:SWANNER, KEVIN LEE (APRN)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LEE
Last Name:SWANNER
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Gender:M
Credentials:APRN
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Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:606-864-2179
Mailing Address - Fax:606-864-7484
Practice Address - Street 1:2135 HIGHWAY 30 BYP
Practice Address - Street 2:SUITE 1
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6139
Practice Address - Country:US
Practice Address - Phone:606-864-2179
Practice Address - Fax:606-864-1484
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2014-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3008706363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily