Provider Demographics
NPI:1770974651
Name:MCSWAIN, ERNESTINE (LPN)
Entity type:Individual
Prefix:
First Name:ERNESTINE
Middle Name:
Last Name:MCSWAIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2798 RIDGEPOLE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-9504
Mailing Address - Country:US
Mailing Address - Phone:931-614-6393
Mailing Address - Fax:
Practice Address - Street 1:2798 RIDGEPOLE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-9504
Practice Address - Country:US
Practice Address - Phone:931-614-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000082594164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse