Provider Demographics
NPI:1881672491
Name:MCSWAIN, TERESA IVESTER (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:IVESTER
Last Name:MCSWAIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 EARL RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-6700
Mailing Address - Country:US
Mailing Address - Phone:704-481-0555
Mailing Address - Fax:704-481-9169
Practice Address - Street 1:419 EARL RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-6700
Practice Address - Country:US
Practice Address - Phone:704-481-0555
Practice Address - Fax:704-481-9169
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200967363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8966816Medicaid
NC8966816Medicaid
NC2806035Medicare PIN