Provider Demographics
NPI:1376953513
Name:SWISTEK, YASMINE
Entity Type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:SWISTEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 FORREST CROSSING BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5429
Mailing Address - Country:US
Mailing Address - Phone:423-894-0432
Mailing Address - Fax:
Practice Address - Street 1:7550 GOODWIN RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3182
Practice Address - Country:US
Practice Address - Phone:423-894-3252
Practice Address - Fax:423-894-2237
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily