Individual
SHANNON LEE SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2750 MAIN ST STE 2, MARLETTE, MI 48453
(989) 635-4104
(877) 762-6751
Mailing address
1100 S VAN DYKE RD, BAD AXE, MI 48413-9615
(989) 269-9521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704254119
MI
Other
Enumeration date
11/18/2015
Last updated
07/28/2020
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