Provider Demographics
NPI:1851999593
Name:SWAYZE, NIKI L (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:NIKI
Middle Name:L
Last Name:SWAYZE
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 JOHN STREET
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2428
Mailing Address - Country:US
Mailing Address - Phone:908-296-7673
Mailing Address - Fax:
Practice Address - Street 1:25 JOHN STREET
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2428
Practice Address - Country:US
Practice Address - Phone:908-296-7673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO12239500163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty