Provider Demographics
NPI:1912515883
Name:SWIFT, JENNIFER ANNE (MT, CHS, MHA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:MT, CHS, MHA
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:DEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT, CHS, MHA
Mailing Address - Street 1:302 GLENVIEW LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9478
Mailing Address - Country:US
Mailing Address - Phone:919-370-6615
Mailing Address - Fax:
Practice Address - Street 1:14 CIRCUIT DR RM 116
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3051
Practice Address - Country:US
Practice Address - Phone:919-684-3089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
No246QM0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMicrobiology