Provider Demographics
NPI:1215493861
Name:SWAIN, CHELMENSE
Entity type:Individual
Prefix:
First Name:CHELMENSE
Middle Name:
Last Name:SWAIN
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 1:1355 COMMERCE DR APT 1006
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-2851
Mailing Address - Country:US
Mailing Address - Phone:256-872-1213
Mailing Address - Fax:
Practice Address - Street 1:1355 COMMERCE DR APT 1006
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-2851
Practice Address - Country:US
Practice Address - Phone:256-872-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
B4B5G4F7247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other