Provider Demographics
NPI:1083165278
Name:SWANN, ROBBIN (RN)
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:
Last Name:SWANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ROBBIN
Other - Middle Name:ELLEN
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, IBCLC
Mailing Address - Street 1:210 COUNTY ROAD 221
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-7343
Mailing Address - Country:US
Mailing Address - Phone:903-316-1927
Mailing Address - Fax:
Practice Address - Street 1:210 COUNTY ROAD 221
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-7343
Practice Address - Country:US
Practice Address - Phone:512-363-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-22
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX701722163WX0003X
TX7-1733163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient