Provider Demographics
NPI:1710370705
Name:SWINDOLL, JEANINE B (FNP- BC)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:B
Last Name:SWINDOLL
Suffix:
Gender:F
Credentials:FNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST # MS 8103
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-2800
Mailing Address - Fax:806-743-2784
Practice Address - Street 1:3601 4TH ST # MS 8103
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430
Practice Address - Country:US
Practice Address - Phone:806-743-2800
Practice Address - Fax:806-743-2784
Is Sole Proprietor?:No
Enumeration Date:2015-03-15
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX501605363LF0000X
TXAP127349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily