MRS. STACEY ANN SWANSON (NPI# 1447588454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447588454 |
| Entity Type | Individual |
| Full Name | MRS. STACEY ANN SWANSON |
| Other Name | MS. STACEY ANN WILCOX |
| Credential | PA-C |
| Practice Address |
532 Main St Ste 1 Moosic PA 18507-1001 |
| Practice Telephone | 5704713569 |
| Practice Fax Number | 5704717052 |
| Mailing Telephone | 5704713569 |
| Mailing Fax Number | 5704717052 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2014-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA053984 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | P00855364 | 01 |
| Street Address |
532 MAIN ST STE 1 |
| City | MOOSIC |
| State | PA |
| Zip Code | 18507-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184270969 | Frances R Acker- Pisko | Massage Therapist | 540 Gleason Drive, Moosic, PA 18507 | 2019-08-16 |
| 1457854150 | Leanna Tabatabaie | Dietitian, Registered | 532 Main St Ste 3, Moosic, PA 18507 | 2018-03-09 |
| 1689092769 | James Vito Squadrito Jr. | Physical Therapist | 3356 Birney Plaza, Pro Rehabilitation Services, Moosic, PA 18507 | 2014-04-04 |
| 1871881573 | Ethical Factor Rx LLC | Durable Medical Equipment & Medical Supplies | 4213 Birney Ave, Suite 4, Moosic, PA 18507 | 2011-07-14 |
| 1508955725 | Edward Christopher Grambo | Dentist | 3812 Birney Ave, Moosic, PA 18507 | 2006-10-12 |
| 1316044431 | Moosic Dental Group Inc | Dentist | 502 Church Street, Moosic, PA 18507 | 2006-09-20 |
| 1528047347 | Ralph Demario | Internal Medicine | 340 Momtage Mt Road, Moosic, PA 18507 | 2006-01-11 |
| 1023658895 | Ichs Corporatioin | Clinic/Center | 73 Montage Mountain Road, Moosic, PA 18507 | 2020-01-09 |
| 1285012526 | Laura Herbener | Nurse Practitioner | 53 Glenmaura National Blvd, Moosic, PA 18507 | 2015-05-06 |
| 1104266824 | Travis Edward Perry | Dentist | 502 Church Street, Moosic, PA 18507 | 2013-06-26 |
| Find all providers in zip 18507 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548365166 | Julie Oja | Physician Assistant | 340 Montage Mountain Road, Moosic, PA 18507-1782 | 2006-09-14 |
| 1699251728 | Casey Rae Kasisky | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2018-07-11 |
| 1053780981 | Matthew Vinnacombe | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2015-09-22 |
| 1427453638 | Dayna Ruhf | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2014-10-30 |
| 1548681323 | Tracy Lynn Jayne | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2013-12-23 |
| 1013338920 | Joseph Feistl | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2013-12-18 |
| 1003193202 | Amanda Lyn Fidiam | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2011-11-16 |
| 1104122233 | Kacey A Tomko | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507 | 2011-02-08 |
| 1134421183 | Jade Lynn Holley | Physician Assistant | 532 Main St, Suite 1, Moosic, PA 18507-1001 | 2010-11-24 |
| 1245462696 | Daryl Krouse | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2009-08-19 |
| Find all providers in MOOSIC | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.