Healthcare Provider Details

I. General information

NPI: 1902062458
Provider Name (Legal Business Name): VERONICA DOUGLAS SWINSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date: 12/06/2021
Reactivation Date: 02/26/2026

III. Provider practice location address

929 W PROSPECT RD
RAEFORD NC
28376-9543
US

IV. Provider business mailing address

5728 PEPPERBUSH DR
FAYETTEVILLE NC
28304-4827
US

V. Phone/Fax

Practice location:
  • Phone: 910-904-1695
  • Fax: 910-904-1767
Mailing address:
  • Phone: 910-423-8973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number297086
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: