Healthcare Provider Details

I. General information

NPI: 1821749771
Provider Name (Legal Business Name): CAROLINE SWIHART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 MONROE ST STE 204
TOLEDO OH
43623-3467
US

IV. Provider business mailing address

1151 OTTAWA DR
PORT CLINTON OH
43452-2239
US

V. Phone/Fax

Practice location:
  • Phone: 419-865-5690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN.267572
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: