Individual provider · NPI-1
Raeanna Swenson
Technician · Brooklyn Park, MN
NPI number1366233181
StatusActive
Last updated in NPPESMay 13, 2025
Details
- NPI
- 1366233181
- Entity type
- Individual (NPI-1)
- Name
- Raeanna Swenson
- Sole proprietor
- No
- Enumeration date
- May 13, 2025
- Certification date
- May 13, 2025
- Last updated
- May 13, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374700000X | Technician | – | – | Yes |
Practice location
5500 94th Ave NBrooklyn Park, MN 55443-1992
Phone 952-567-6601 · Fax 952-567-6601
Mailing address
5500 94th Ave NBrooklyn Park, MN 55443-1992
Phone 952-567-6601 · Fax 952-567-6601
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