Individual
MARYANNE SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
317 E 11 MILE RD, ROYAL OAK, MI 48067-2735
(248) 336-2868
(248) 336-2879
Mailing address
5768 BULLARD RD, FENTON, MI 48430-9409
(248) 310-6295
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704135700
MI
363LA2200X
Adult Health Nurse Practitioner
4704135700
MI
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
4704135700
MI
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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