Doctor Name: | JEANETTE S SWAYZE |
NPI Number: | 1225045412 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | R16525 |
Business Practice Address: | 649 County Road 515 Ignacio, CO - 811379711 |
Business Phone Number: | 9708842479 |
Business Fax Number: | |
Mailing Address: | 649 County Road 515, IGNACIO |
State: | CO |
Postal Code: | 811379711 |
Phone Number: | 9708842479 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | R16525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |