Individual
DEBRA SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
1115 W OAK ST, SOUTH BEND, IN 46616-1014
(574) 252-1975
Mailing address
1115 W OAK ST, SOUTH BEND, IN 46616-1014
(574) 252-1795
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85-3886778
—
IN
Enumeration date
11/17/2020
Last updated
11/17/2020
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