Individual
JESSICA L SWENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 BRENDON WAY, SUITE 800, ZIONSVILLE, IN 46077-1955
(317) 777-6400
(317) 777-6410
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01052923A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000313041
ANTHEM
IN
05
—
201155110
—
IN
01
—
P00116645
RR MEDICARE
IN
Enumeration date
07/20/2006
Last updated
02/27/2014
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