Basic Information
Provider Information
NPI: 1225496185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SWINNEY
FirstName: ERICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 140 WHITTINGTON PKWY STE 100
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402224930
CountryCode: US
TelephoneNumber: 5023279100
FaxNumber: 8556328329
Practice Location
Address1: 8888 KEYSTONE XING
Address2: STE 1300
City: INDIANAPOLIS
State: IN
PostalCode: 462404609
CountryCode: US
TelephoneNumber: 8664603567
FaxNumber: 8556328329
Other Information
ProviderEnumerationDate: 02/08/2016
LastUpdateDate: 02/18/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3010070KYN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X71006086AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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