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General NPI Number Information
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NPI Number | 1790084812
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Entity Type | Individual
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Provider Name | MARY MICHELLE SWINDALL CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 3000 ROSA L PARKS AVE
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City | MONTGOMERY
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State | AL
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Zip | 36105-1502
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Country | US
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Telephone | 334-777-1290
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Fax | 334-746-7968
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Provider Business Mailing Address
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Address Line | PO BOX 746063
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City | ATLANTA
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State | GA
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Zip | 30374-6063
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Country | US
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Telephone | 312-733-9730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-076706
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License Number State | AL
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