Provider Demographics
NPI:1023332699
Name:SWICK, JACLYN K (PA-C)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:K
Last Name:SWICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:107 STAUNTON DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-5604
Mailing Address - Country:US
Mailing Address - Phone:304-269-2022
Mailing Address - Fax:304-269-2037
Practice Address - Street 1:107 STAUNTON DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-5604
Practice Address - Country:US
Practice Address - Phone:304-269-2022
Practice Address - Fax:304-269-2037
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2022-08-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant