Healthcare Provider Details

I. General information

NPI: 1750849477
Provider Name (Legal Business Name): MRS. TONYA HAGINES SWINNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 HOLLAND DR
ALBANY GA
31705-3707
US

IV. Provider business mailing address

813 HOLLAND DR
ALBANY GA
31705-3707
US

V. Phone/Fax

Practice location:
  • Phone: 229-449-9099
  • Fax: 229-638-0372
Mailing address:
  • Phone: 229-449-9099
  • Fax: 229-638-0372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN046238
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: