Provider Demographics
NPI:1699473744
Name:SWAVING, KATHERINE (CLC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SWAVING
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 COOL BROOK TRL
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2819
Mailing Address - Country:US
Mailing Address - Phone:757-635-1346
Mailing Address - Fax:
Practice Address - Street 1:1233 COOL BROOK TRL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2819
Practice Address - Country:US
Practice Address - Phone:757-635-1346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
MA336094174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula