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Individual

MIRANDA SWINEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
601 STATE ROUTE 664 N, LOGAN, OH 43138
(740) 380-3314
Mailing address
601 STATE ROUTE 664 N, LOGAN, OH 43138-8541

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0027816
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0424873
OH
Enumeration date
06/05/2019
Last updated
12/28/2020
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