Provider Demographics
NPI:1952640955
Name:SWANEY, JENNIFER MANION (ARNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MANION
Last Name:SWANEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 NE 16TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1619
Mailing Address - Country:US
Mailing Address - Phone:954-567-3296
Mailing Address - Fax:
Practice Address - Street 1:3265 DAVIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-2755
Practice Address - Country:US
Practice Address - Phone:954-641-2610
Practice Address - Fax:954-641-2611
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9173375363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner