Provider Demographics
NPI:1346604790
Name:JEAN-MARIE SWAINE, LLC
Entity Type:Organization
Organization Name:JEAN-MARIE SWAINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAINE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-612-5628
Mailing Address - Street 1:2450 GRANADA BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1341
Mailing Address - Country:US
Mailing Address - Phone:702-612-5628
Mailing Address - Fax:
Practice Address - Street 1:2450 GRANADA BLUFF CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1341
Practice Address - Country:US
Practice Address - Phone:702-612-5628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20161097552282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital