Provider Demographics
NPI:1457544033
Name:SWATZELL, VICTORIA M (DNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:M
Last Name:SWATZELL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6432
Mailing Address - Country:US
Mailing Address - Phone:480-882-6640
Mailing Address - Fax:480-882-4684
Practice Address - Street 1:855 MONROE AVE STE 415
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-6432
Practice Address - Country:US
Practice Address - Phone:901-866-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2728363LA2200X
TN19569363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ011503Medicaid
MS08386361Medicaid
AR207409758Medicaid