Provider Demographics
NPI:1053618827
Name:SWIFT, SHARNTIVIA JACQUISE (LPN)
Entity type:Individual
Prefix:
First Name:SHARNTIVIA
Middle Name:JACQUISE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 N CROW RD APT D
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-4393
Mailing Address - Country:US
Mailing Address - Phone:850-221-0007
Mailing Address - Fax:
Practice Address - Street 1:790 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-1000
Practice Address - Country:US
Practice Address - Phone:866-927-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5194355164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse