1356574974 NPI number — DR. CATHERINE NICOLE SWING PHARMD

Table of content: DR. CATHERINE NICOLE SWING PHARMD (NPI 1356574974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356574974 NPI number — DR. CATHERINE NICOLE SWING PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWING
Provider First Name:
CATHERINE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEARCE
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356574974
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16812 S MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALESVILLE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54630-7704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-582-2446
Provider Business Mailing Address Fax Number:
608-582-4321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
918 W PLATT ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
MAQUOKETA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52060-2038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-652-5211
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  15574-40 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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