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Individual

ANSLEY SWANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, ATC

Contact information

Practice address
11221 GALLERIA AVE STE 101, RALEIGH, NC 27614-8137
(919) 562-9410
Mailing address
1243 PATRICK CIR APT B, CARY, NC 27511-4929
(704) 989-1856

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
LAT-5840
NC
2255A2300X
Athletic Trainer
Primary
TCA735
KY
363A00000X
Physician Assistant
Primary
0010-16224
NC

Other

Enumeration date
07/29/2019
Last updated
03/23/2026
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