Provider Demographics
NPI:1588092399
Name:OCEANSIDE FAMILY MEDICINE
Entity type:Organization
Organization Name:OCEANSIDE FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:910-409-1658
Mailing Address - Street 1:5145 SELLERS RD
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-3405
Mailing Address - Country:US
Mailing Address - Phone:910-754-4441
Mailing Address - Fax:
Practice Address - Street 1:5145 SELLERS RD
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-3405
Practice Address - Country:US
Practice Address - Phone:910-754-4441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty