Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 95011762 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | 95011762 | CA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95011762 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 95011762 | CA |
NPI | 1346802840 |
---|---|
Provider Name | Shakeela Swaby |
First Address | Pasadena, CA 91105-2621 |
Second Address | Pasadena, CA 91105-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2019 |
Last Update Date | 26/09/2019 |