Provider Demographics
NPI:1386832236
Name:SWOAPE, TONYA DARLENE (MS,RD,LDN,CDE)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:DARLENE
Last Name:SWOAPE
Suffix:
Gender:F
Credentials:MS,RD,LDN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 SPARKMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38581-7636
Mailing Address - Country:US
Mailing Address - Phone:931-686-8870
Mailing Address - Fax:
Practice Address - Street 1:629 SPARKMANTOWN RD
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:TN
Practice Address - Zip Code:38581-7636
Practice Address - Country:US
Practice Address - Phone:931-686-8870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000000798133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered