Healthcare Provider Details

I. General information

NPI: 1669863049
Provider Name (Legal Business Name): ROBIN SWAYNE CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15700 SHAWNEE MISSION PKWY
SHAWNEE KS
66217-9321
US

IV. Provider business mailing address

15700 SHAWNEE MISSION PKWY
SHAWNEE KS
66217-9321
US

V. Phone/Fax

Practice location:
  • Phone: 913-962-5199
  • Fax:
Mailing address:
  • Phone: 913-962-5199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number14-13279
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: