Individual
KELLY O'NEILL SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-5948
Mailing address
120 CHRISTOPHER ST APT 2, NEW YORK, NY 10014-4239
(407) 733-6581
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382448
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/11/2013
Last updated
07/21/2022
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