Basic Information
| Provider Information | |||||||||
| NPI: | 1699361501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWAIN | ||||||||
| FirstName: | HAYLEY | ||||||||
| MiddleName: | MICHELE | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 424 LINDEN ST | ||||||||
| Address2: | |||||||||
| City: | LUDLOW | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410161439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135354100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 E FLORENCE BLVD | ||||||||
| Address2: | |||||||||
| City: | CASA GRANDE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851225303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203816300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2020 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 458758 | OH | Y | Nursing Service Providers | Registered Nurse |
No ID Information.