Provider Demographics
NPI:1104284850
Name:SWINNEY, DANITA
Entity type:Individual
Prefix:
First Name:DANITA
Middle Name:
Last Name:SWINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANITA
Other - Middle Name:G
Other - Last Name:SWINNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:3735 WOODRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1860
Mailing Address - Country:US
Mailing Address - Phone:216-609-5594
Mailing Address - Fax:
Practice Address - Street 1:3735 WOODRIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44121-1860
Practice Address - Country:US
Practice Address - Phone:216-609-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-09
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OHRR192822343900000X
OH374U00000X
OH472327163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No374U00000XNursing Service Related ProvidersHome Health Aide