Provider Demographics
NPI:1942855986
Name:SWYGERT, JAMIL'YA ALEXIS
Entity Type:Individual
Prefix:
First Name:JAMIL'YA
Middle Name:ALEXIS
Last Name:SWYGERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMILYA
Other - Middle Name:ALEXIS
Other - Last Name:SWYGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JAMIL'YA HARRIS
Mailing Address - Street 1:407 N BROWN ST
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-5710
Mailing Address - Country:US
Mailing Address - Phone:803-733-5969
Mailing Address - Fax:
Practice Address - Street 1:407 N BROWN ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-5710
Practice Address - Country:US
Practice Address - Phone:803-733-5969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23094363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care