Individual
JOAN SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1540 SUNDAY DR, RALEIGH, NC 27607-6010
(919) 782-3456
(919) 783-1441
Mailing address
1540 SUNDAY DR, RALEIGH, NC 27607-6010
(919) 782-3456
(919) 783-1441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06311
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-06311
NC LICENSE
NC
01
—
1132271
NCCPA
NC
Enumeration date
05/20/2016
Last updated
05/20/2016
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