Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R098213 | MD |
NPI | 1023086741 |
---|---|
Provider Name | Ms. Linda Jean Swallow |
First Address | Glen Burnie, MD 21061-5805 |
Second Address | Glen Burnie, MD 21061-5805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 14/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
621731100 | (05) | MD |
S67331 | (02) | MD |