Provider Demographics
NPI:1366020588
Name:SWAFFORD, REBECCA L (APN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 MUDDY POND RD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:TN
Mailing Address - Zip Code:38574-3829
Mailing Address - Country:US
Mailing Address - Phone:931-787-8317
Mailing Address - Fax:
Practice Address - Street 1:4147 HIGHWAY 127 N STE 102
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38571-7521
Practice Address - Country:US
Practice Address - Phone:931-484-2220
Practice Address - Fax:931-484-2220
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily