Healthcare Provider Details

I. General information

NPI: 1801086442
Provider Name (Legal Business Name): MISS JOYCE A SWINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 HWY 152 EAST
ROCKWELL NC
28138-8874
US

IV. Provider business mailing address

7120 HWY 152 EAST
ROCKWELL NC
28138-8874
US

V. Phone/Fax

Practice location:
  • Phone: 704-279-4061
  • Fax: 704-279-4061
Mailing address:
  • Phone: 704-279-4061
  • Fax: 704-279-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License NumberFCL 080 015
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: