Healthcare Provider Details

I. General information

NPI: 1386074664
Provider Name (Legal Business Name): KRISTEN SWIFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN SAWYERS

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 SIGNER BLVD APT D
HONOLULU HI
96818-4975
US

IV. Provider business mailing address

302 SIGNER BLVD APT D
FPO AP
96818-4975
US

V. Phone/Fax

Practice location:
  • Phone: 410-920-8104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR165070
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM1357
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: