Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 11003058 | FL |
NPI | 1043872229 |
---|---|
Provider Name | Jessie M Swisher |
First Address | Kissimmee, FL 34741-4924 |
Second Address | Kissimmee, FL 34741-4996 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2019 |
Last Update Date | 27/11/2019 |