Healthcare Provider Details

I. General information

NPI: 1497773634
Provider Name (Legal Business Name): JENNIFER WARREN SWEARINGEN P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BILLINGSLEY RD STE 200
CHARLOTTE NC
28211-1084
US

IV. Provider business mailing address

3426 TORINGDON WAY STE 108
CHARLOTTE NC
28277-3497
US

V. Phone/Fax

Practice location:
  • Phone: 704-372-7974
  • Fax: 704-372-8201
Mailing address:
  • Phone: 704-372-7974
  • Fax: 704-372-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number103749
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: