Provider Demographics
NPI:1538598552
Name:SWINBOURNE, DEBORAH (RDN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SWINBOURNE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SOUTHWELL RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1219
Mailing Address - Country:US
Mailing Address - Phone:207-939-1511
Mailing Address - Fax:207-799-2769
Practice Address - Street 1:6 SOUTHWELL RD
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-1219
Practice Address - Country:US
Practice Address - Phone:207-939-1511
Practice Address - Fax:207-799-2769
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI1101133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered