Provider Demographics
NPI:1578000949
Name:SWANK, STACEY (RN)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:
Last Name:SWANK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 BECKETT CENTER DR
Mailing Address - Street 2:SUITE 217
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5026
Mailing Address - Country:US
Mailing Address - Phone:513-860-0851
Mailing Address - Fax:513-860-2302
Practice Address - Street 1:8080 BECKETT CENTER DR
Practice Address - Street 2:SUITE 217
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5026
Practice Address - Country:US
Practice Address - Phone:513-860-0851
Practice Address - Fax:513-860-2302
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide