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Individual

ANGELA DENISE SWAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
3405 DALLAS HWY SW STE 300, MARIETTA, GA 30064-6426
(770) 425-5331
(770) 425-0799
Mailing address
3405 DALLAS HWY SW STE 300, MARIETTA, GA 30064-6426
(770) 425-5331
(770) 425-0799

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
124349
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000944853F
GA
05
000944853J
GA
Enumeration date
01/08/2007
Last updated
03/03/2014
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