Healthcare Provider Details

I. General information

NPI: 1205767167
Provider Name (Legal Business Name): CHRISTINE MARIE SWARTOUT LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12951 WALSINGHAM RD
LARGO FL
33774-3538
US

IV. Provider business mailing address

12951 WALSINGHAM RD
LARGO FL
33774-3538
US

V. Phone/Fax

Practice location:
  • Phone: 727-391-0158
  • Fax:
Mailing address:
  • Phone: 727-391-0158
  • Fax: 727-392-5192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN5185064
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: