Provider Demographics
NPI:1578286480
Name:SWOPE, CANDY ANN (LPN)
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:ANN
Last Name:SWOPE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 S CARAWAY RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-0639
Mailing Address - Country:US
Mailing Address - Phone:870-938-3874
Mailing Address - Fax:
Practice Address - Street 1:4305 S CARAWAY RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-0639
Practice Address - Country:US
Practice Address - Phone:870-938-3874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL041569164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse