Individual
ASHLEY SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,FNP-C
Contact information
Practice address
1571 WASHINGTON ST STE 107, WATERTOWN, NY 13601-9304
(315) 782-7330
Mailing address
1571 WASHINGTON ST STE 107, WATERTOWN, NY 13601-9304
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN10017012
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370717503
DRIVER LICENSE
NY
Enumeration date
07/16/2020
Last updated
01/10/2025
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