Healthcare Provider Details

I. General information

NPI: 1235040957
Provider Name (Legal Business Name): TAYLOR SWEIGART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR FAKE

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 GROVE RD
GREENVILLE SC
29605-4208
US

IV. Provider business mailing address

246 BRYLAND WAY
FOUNTAIN INN SC
29644-1967
US

V. Phone/Fax

Practice location:
  • Phone: 864-656-7622
  • Fax:
Mailing address:
  • Phone: 610-763-8194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number258545
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: