Healthcare Provider Details

I. General information

NPI: 1548072119
Provider Name (Legal Business Name): REBECCA LEE SWAFFORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 MCBRIEN RD
EAST RIDGE TN
37412-3223
US

IV. Provider business mailing address

446 AL HIGHWAY 73
BRYANT AL
35958-5012
US

V. Phone/Fax

Practice location:
  • Phone: 423-894-3589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-178927
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: