Provider Demographics
NPI:1669708848
Name:SWINEY, WENDY D (FNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:D
Last Name:SWINEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 PEMBERTON RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-7746
Mailing Address - Country:US
Mailing Address - Phone:423-341-4248
Mailing Address - Fax:423-857-2070
Practice Address - Street 1:375 LIBERTY PL
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-2593
Practice Address - Country:US
Practice Address - Phone:276-669-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014486363LA2200X
VA0024169019363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health