Provider Demographics
NPI:1245871144
Name:SWEEZEY, LAURIE
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:SWEEZEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:CA
Mailing Address - Zip Code:96027-9701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2918 ISLAND RD
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:CA
Practice Address - Zip Code:96027-9701
Practice Address - Country:US
Practice Address - Phone:530-467-5282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider