Provider Demographics
NPI:1790462869
Name:SWARTZ, KATIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 S HIGHLAND DR UNIT 607
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-4794
Mailing Address - Country:US
Mailing Address - Phone:330-749-3861
Mailing Address - Fax:
Practice Address - Street 1:11576 S STATE ST STE 101B
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7126
Practice Address - Country:US
Practice Address - Phone:801-999-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024874363LF0000X
UT14197236-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily