Provider Demographics
NPI:1992013981
Name:SWARAY, JENEBA MIMIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JENEBA
Middle Name:MIMIE
Last Name:SWARAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 HARNET CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-8720
Mailing Address - Country:US
Mailing Address - Phone:614-638-1282
Mailing Address - Fax:
Practice Address - Street 1:2831 HARNET CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-8720
Practice Address - Country:US
Practice Address - Phone:614-638-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 136199-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse