Individual
KEITH R SWAINSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1130 E FAIRVIEW AVE, MERIDIAN, ID 83642-1813
(208) 895-6729
(208) 855-5921
Mailing address
PO BOX 314, MERIDIAN, ID 83680-0314
(208) 895-6729
(208) 855-5921
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-823A
ID
363LF0000X
Family Nurse Practitioner
21058.315
WY
Other
Enumeration date
09/08/2005
Last updated
03/17/2021
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