MEDICARE: MRS. TERESA IVESTER MCSWAIN FNP

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	200967	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881672491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA IVESTER MCSWAIN FNP

Provider Business Mailing Address
First Line	:	419 EARL RD
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-6700
Country	:	US
Telephone Number	:	704-481-0555
Fax Number	:	704-481-9169

Provider Business Practice Location Address
First Line	:	419 EARL RD
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-6700
Country	:	US
Telephone Number	:	704-481-0555
Fax Number	:	704-481-9169

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	08/23/2023

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