Provider Demographics
NPI:1497773634
Name:SWEARINGEN, JENNIFER WARREN (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:WARREN
Last Name:SWEARINGEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11301 CARMEL COMMONS BLVD
Mailing Address - Street 2:STE 302
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5305
Mailing Address - Country:US
Mailing Address - Phone:704-372-7974
Mailing Address - Fax:704-372-8201
Practice Address - Street 1:300 BILLINGSLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1084
Practice Address - Country:US
Practice Address - Phone:704-372-7974
Practice Address - Fax:704-372-8201
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2017-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC103749363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP89677Medicare UPIN