Provider Demographics
NPI:1861981425
Name:SWIES, CORTNIE (TM)
Entity type:Individual
Prefix:MRS
First Name:CORTNIE
Middle Name:
Last Name:SWIES
Suffix:
Gender:F
Credentials:TM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 E LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1217
Mailing Address - Country:US
Mailing Address - Phone:614-370-9295
Mailing Address - Fax:
Practice Address - Street 1:182 E LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1217
Practice Address - Country:US
Practice Address - Phone:614-370-9295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
TN210400006367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty