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Individual

JULIE LYNN SWANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2316 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2149
(702) 877-8600
(702) 667-4651
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 579-3270
(702) 667-4651

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10701
NV
207Q00000X
Family Medicine Physician
Primary
12489
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457655482
SMA MEDICAID
NV
01
V111463
SMA MEDICARE
NV
Enumeration date
01/05/2011
Last updated
09/15/2015
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