Provider Demographics
NPI:1841062130
Name:SWIFT, NICHOLE E
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:E
Last Name:SWIFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 VIA PONDEROSA FL 1
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5520
Mailing Address - Country:US
Mailing Address - Phone:518-724-9244
Mailing Address - Fax:
Practice Address - Street 1:604 VIA PONDEROSA FL 1
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5520
Practice Address - Country:US
Practice Address - Phone:518-724-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339355-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse