Provider Demographics
NPI:1013640978
Name:SWOPE, JACLYN ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:ELIZABETH
Last Name:SWOPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9909 COBBLE LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-9424
Mailing Address - Country:US
Mailing Address - Phone:479-616-3067
Mailing Address - Fax:
Practice Address - Street 1:9909 COBBLE LN
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-9424
Practice Address - Country:US
Practice Address - Phone:479-616-3067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker