| Doctor Name: | JOBETH ANN SWALLOW |
| NPI Number: | 1063842417 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R039704 |
| Business Practice Address: | East Highway 18 Pine Ridge, SD - 57770 |
| Business Phone Number: | 6058675131 |
| Business Fax Number: | |
| Mailing Address: | East Highway 18, PINE RIDGE |
| State: | SD |
| Postal Code: | 57770 |
| Phone Number: | 6058675131 |
| Fax Number: | |
| NPI Enumeration Date: | 11/22/2013 |
| NPI Last Update Date: | 11/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | R039704 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |