Provider Demographics
NPI:1366677916
Name:SWART, CAROL ANN (RN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:SWART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7074 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8658
Mailing Address - Country:US
Mailing Address - Phone:352-540-9335
Mailing Address - Fax:352-544-5625
Practice Address - Street 1:7074 GROVE RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34609-8658
Practice Address - Country:US
Practice Address - Phone:352-540-9335
Practice Address - Fax:352-544-5625
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9261679163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse