Provider Demographics
NPI:1194593848
Name:SWIFT, LATONYA NICOLE
Entity type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:NICOLE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 W WENDOVER AVE STE 101A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8192
Mailing Address - Country:US
Mailing Address - Phone:743-249-6115
Mailing Address - Fax:
Practice Address - Street 1:1306 W WENDOVER AVE STE 101A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8192
Practice Address - Country:US
Practice Address - Phone:336-898-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver