Provider Demographics
NPI:1386234631
Name:SWINDLE, PAUL JR (RN, CCM)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SWINDLE
Suffix:JR
Gender:M
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MILL ST
Mailing Address - Street 2:
Mailing Address - City:FLORIEN
Mailing Address - State:LA
Mailing Address - Zip Code:71429-5127
Mailing Address - Country:US
Mailing Address - Phone:318-332-7804
Mailing Address - Fax:
Practice Address - Street 1:1585 3RD ST BLDG 285
Practice Address - Street 2:
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:337-531-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN061167163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management