Provider Demographics
NPI:1184052516
Name:SWANSON, DINA G (APRN-FPA, FNP-BC)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:G
Last Name:SWANSON
Suffix:
Gender:F
Credentials:APRN-FPA, FNP-BC
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:G
Other - Last Name:GABRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARPN-FPA, FNP-BC
Mailing Address - Street 1:723 N LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4384
Mailing Address - Country:US
Mailing Address - Phone:217-213-5808
Mailing Address - Fax:217-213-6290
Practice Address - Street 1:723 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4384
Practice Address - Country:US
Practice Address - Phone:217-213-5808
Practice Address - Fax:217-213-6290
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010779363L00000X
IL277.000250363LA2200X, 363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics