Provider Demographics
NPI:1053837369
Name:SWOFFORD, MELISSA CANTRELL (NP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:CANTRELL
Last Name:SWOFFORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349 BATTLEGROUND RD
Mailing Address - Street 2:
Mailing Address - City:COWPENS
Mailing Address - State:SC
Mailing Address - Zip Code:29330-9437
Mailing Address - Country:US
Mailing Address - Phone:864-809-9249
Mailing Address - Fax:
Practice Address - Street 1:151 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3016
Practice Address - Country:US
Practice Address - Phone:864-345-1020
Practice Address - Fax:877-215-1965
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily