Healthcare Provider Details

I. General information

NPI: 1649924283
Provider Name (Legal Business Name): SENTA SWART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6734 LAKEVIEW BLVD APT 17104
WESTLAND MI
48185-6603
US

IV. Provider business mailing address

6734 LAKEVIEW BLVD APT 17104
WESTLAND MI
48185-6603
US

V. Phone/Fax

Practice location:
  • Phone: 800-231-1127
  • Fax:
Mailing address:
  • Phone: 160-261-6027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number1959844
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: