Individual
DALLAS SWIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
PO BOX 354, NARROWS, VA 24124-0354
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001-058459
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024-058459
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8935076
—
VA
05
—
8935084
—
VA
05
—
8935092
—
VA
05
—
8935254
—
VA
05
—
8935262
—
VA
Enumeration date
08/02/2006
Last updated
05/05/2008
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