Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP017560 | PA |
NPI | 1003344144 |
---|---|
Provider Name | Brandon David Swisher |
First Address | State College, PA 16801-7249 |
Second Address | Philipsburg, PA 16866-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2017 |
Last Update Date | 02/06/2017 |