Provider Demographics
NPI:1952684219
Name:SWAFFORD, JODI (CRNP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 LEIGHTON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5703
Mailing Address - Country:US
Mailing Address - Phone:256-237-1001
Mailing Address - Fax:256-237-0016
Practice Address - Street 1:901 LEIGHTON AVE STE 103
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5703
Practice Address - Country:US
Practice Address - Phone:256-237-1001
Practice Address - Fax:256-237-0016
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN195459363LA2200X
AL1-124835363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health