Provider Demographics
NPI:1205058393
Name:SWABY, JEAN ISABELLE (NP)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ISABELLE
Last Name:SWABY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1152
Mailing Address - Country:US
Mailing Address - Phone:954-765-4159
Mailing Address - Fax:954-765-4075
Practice Address - Street 1:161 NW 207TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-3501
Practice Address - Country:US
Practice Address - Phone:954-765-4159
Practice Address - Fax:954-765-4075
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1329382163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics