Provider Demographics
NPI:1558509364
Name:SWIGART, CHRISTINA MICHELE (LN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MICHELE
Last Name:SWIGART
Suffix:
Gender:F
Credentials:LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7445 96TH ST S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3866
Mailing Address - Country:US
Mailing Address - Phone:651-335-2334
Mailing Address - Fax:
Practice Address - Street 1:7445 96TH ST S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3866
Practice Address - Country:US
Practice Address - Phone:651-335-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2011-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN191133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist