Basic Information
| Provider Information | |||||||||
| NPI: | 1982113171 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWENGEL | ||||||||
| FirstName: | SARAH | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8412 MARTINS CREEK RD | ||||||||
| Address2: | |||||||||
| City: | ROANOKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240185862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849411562 | ||||||||
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| Practice Location | |||||||||
| Address1: | 705 CLEARVIEW DR | ||||||||
| Address2: | |||||||||
| City: | VINTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 241793605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409826691 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2017 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C0006599 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0110006644 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.