Provider Demographics
NPI:1629349659
Name:SWISHER, ANNA (MBA, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:SWISHER
Suffix:
Gender:F
Credentials:MBA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BASTIAN LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-2076
Mailing Address - Country:US
Mailing Address - Phone:512-577-5108
Mailing Address - Fax:512-682-9124
Practice Address - Street 1:319 BASTIAN LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-2076
Practice Address - Country:US
Practice Address - Phone:512-577-5108
Practice Address - Fax:512-682-9124
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN