MEDICARE: SWAPNA VACHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5023678	NC
2	363LF0000X	Family Nurse Practitioner	26NJ15564300	NJ
3	363LF0000X	Family Nurse Practitioner	NP156882	GA

General Provider Information

NPI Number	:	1174582167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SWAPNA VACHA

Provider Business Mailing Address
First Line	:	2782 N COBB PKWY
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30152-3472
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	2782 N COBB PKWY
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30152-3472
Country	:	US
Telephone Number	:	877-993-4321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	05/11/2026

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Directions to “ SWAPNA VACHA ” Practice Location

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