Provider Demographics
NPI:1073109237
Name:SWAGGARD, SYLVIA MICHELLE (LPN)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:MICHELLE
Last Name:SWAGGARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BANNARD AVE
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-6211
Mailing Address - Country:US
Mailing Address - Phone:716-526-7447
Mailing Address - Fax:
Practice Address - Street 1:17 BANNARD AVE
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-6211
Practice Address - Country:US
Practice Address - Phone:716-526-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329896164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse