Individual
ASHLEY SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
525 KENOSHA ST STE A, WALWORTH, WI 53184-9512
(262) 275-2101
(262) 275-0752
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 275-2101
(262) 275-0752
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13922
WI
363L00000X
Nurse Practitioner
242029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238163
—
WI
Enumeration date
05/11/2023
Last updated
07/25/2023
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