Provider Demographics
NPI:1407614811
Name:MCSWAIN, KYRIE LEIGH
Entity Type:Individual
Prefix:
First Name:KYRIE
Middle Name:LEIGH
Last Name:MCSWAIN
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 1:105 ASHLEY BLUFFS RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-6043
Mailing Address - Country:US
Mailing Address - Phone:843-530-1088
Mailing Address - Fax:
Practice Address - Street 1:105 ASHLEY BLUFFS RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-6043
Practice Address - Country:US
Practice Address - Phone:843-530-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC228812163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine