Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP113993 | TX |
NPI | 1023348802 |
---|---|
Provider Name | Brittaney Elliott Swift |
First Address | Austin, TX 78758-5369 |
Second Address | Austin, TX 78758-5369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2009 |
Last Update Date | 14/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
175597702 | (05) | TX |