Healthcare Provider Details

I. General information

NPI: 1124044144
Provider Name (Legal Business Name): DENISE ALEXANDER SWANK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE G ALEXANDER N.P.

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75036 GERALD FORD DR
PALM DESERT CA
92211-2080
US

IV. Provider business mailing address

75-306 GERALD FORD DRIVE
PALM DESERT CA
92260-2591
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-2500
  • Fax:
Mailing address:
  • Phone: 760-834-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number388052
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: