Organization
SWAN INTEGRATIVE HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MARIE SWAN APRN, DNP (OWNER)
(860) 325-2679
Entity
Organization
Contact information
Practice address
49 WELLES ST STE 215, GLASTONBURY, CT 06033-4205
(860) 325-2679
(860) 316-4064
Mailing address
PO BOX 290650, WETHERSFIELD, CT 06129-0650
(860) 670-6626
(860) 316-4064
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008069858
—
CT
05
—
008092242
—
CT
Enumeration date
03/01/2016
Last updated
08/02/2024
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