Provider Demographics
NPI:1043824493
Name:SWANGIN, AMANDA (NP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SWANGIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:800-427-1902
Mailing Address - Fax:800-564-5952
Practice Address - Street 1:605 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:NORTH MANCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46962-1857
Practice Address - Country:US
Practice Address - Phone:260-982-1994
Practice Address - Fax:260-479-2996
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN202000191967363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty