Provider Demographics
NPI:1700537362
Name:SWAFFORD, CHARLES II (APRN-CNP)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:SWAFFORD
Suffix:II
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E COTTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-1457
Mailing Address - Country:US
Mailing Address - Phone:501-514-3337
Mailing Address - Fax:
Practice Address - Street 1:2510 COMMONS BLVD STE 160
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3834
Practice Address - Country:US
Practice Address - Phone:937-425-4010
Practice Address - Fax:937-425-4014
Is Sole Proprietor?:No
Enumeration Date:2022-01-15
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030602363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care