Provider Demographics
NPI:1952939340
Name:SWIFT, KAIRIE (CNP-FAMILY)
Entity Type:Individual
Prefix:
First Name:KAIRIE
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:CNP-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:STROUD
Mailing Address - State:OK
Mailing Address - Zip Code:74079-7361
Mailing Address - Country:US
Mailing Address - Phone:918-806-8656
Mailing Address - Fax:
Practice Address - Street 1:3321 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-8011
Practice Address - Country:US
Practice Address - Phone:918-629-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK95055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily