Individual
COLLEEN SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8111
Mailing address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9527207
FL
363LF0000X
Family Nurse Practitioner
1-197885
AL
363LF0000X
Family Nurse Practitioner
Primary
1088908
TX
363LF0000X
Family Nurse Practitioner
11011328
FL
Other
Enumeration date
10/02/2020
Last updated
04/02/2024
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