MEDICARE: JEAN-MARIE SWAINE APRN

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	363L00000X	Nurse Practitioner	APRN002067	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN002067	NV

General Provider Information

NPI Number	:	1265805634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN-MARIE SWAINE APRN

Provider Business Mailing Address
First Line	:	2450 GRANADA BLUFF CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1341
Country	:	US
Telephone Number	:	702-612-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	10217 NIGHTOWL CREEK PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4321
Country	:	US
Telephone Number	:	702-612-5628
Fax Number	:

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

Provider Enumeration Date	:	11/07/2015
Last Update Date	:	04/27/2018

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