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Individual

MR. JAMES M SWAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APNP

Contact information

Practice address
2817 NEW PINERY ROAD, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-0387
(608) 742-4131
(608) 429-3966
Mailing address
2817 NEW PINERY ROAD, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-0387
(608) 742-4131
(608) 429-3966

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3155033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36039800
WI
Enumeration date
08/16/2007
Last updated
01/31/2012
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