Provider Demographics
NPI:1366490468
Name:MCSWEENEY, FAROLYN ANNE (OMD)
Entity Type:Individual
Prefix:DR
First Name:FAROLYN
Middle Name:ANNE
Last Name:MCSWEENEY
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 DART BROOK PL
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4530
Mailing Address - Country:US
Mailing Address - Phone:702-375-2427
Mailing Address - Fax:702-837-8515
Practice Address - Street 1:8975 S PECOS RD
Practice Address - Street 2:SUITE 8C
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7160
Practice Address - Country:US
Practice Address - Phone:702-240-2287
Practice Address - Fax:702-837-8515
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1004171100000X
CA8116171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist