Provider Demographics
NPI:1053682179
Name:SWAIN, WHITNEY D (BA)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:D
Last Name:SWAIN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LA PALOMA DRIVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-1418
Mailing Address - Country:US
Mailing Address - Phone:865-525-0391
Mailing Address - Fax:865-525-0393
Practice Address - Street 1:22510 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-3802
Practice Address - Country:US
Practice Address - Phone:865-525-0391
Practice Address - Fax:865-525-0393
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator