Provider Demographics
NPI:1578837688
Name:SWAYNE, HOPE K (MSN RN)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:K
Last Name:SWAYNE
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W LANDOLT ST
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1515
Mailing Address - Country:US
Mailing Address - Phone:618-713-0996
Mailing Address - Fax:
Practice Address - Street 1:407 W LANDOLT ST
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-1515
Practice Address - Country:US
Practice Address - Phone:618-713-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI153559-30163WH0200X
IL041358507163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health