Provider Demographics
NPI:1013157916
Name:SWINDELL, MELVIN KEITH (RN CEN)
Entity Type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:KEITH
Last Name:SWINDELL
Suffix:
Gender:M
Credentials:RN CEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:KAYENTA
Mailing Address - State:AZ
Mailing Address - Zip Code:86033-0368
Mailing Address - Country:US
Mailing Address - Phone:928-697-4167
Mailing Address - Fax:
Practice Address - Street 1:HWY 160/163 BLDG KA-2010
Practice Address - Street 2:
Practice Address - City:KAYENTA
Practice Address - State:AZ
Practice Address - Zip Code:86033
Practice Address - Country:US
Practice Address - Phone:928-697-4167
Practice Address - Fax:928-697-4167
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2517230163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency