Provider Demographics
NPI:1821407222
Name:SWIFT, MESCHELLE (DPH)
Entity Type:Individual
Prefix:
First Name:MESCHELLE
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4527
Mailing Address - Country:US
Mailing Address - Phone:615-238-0126
Mailing Address - Fax:
Practice Address - Street 1:780 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4527
Practice Address - Country:US
Practice Address - Phone:615-238-0126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009975183500000X
TN0000011988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist