Healthcare Provider Details

I. General information

NPI: 1619853454
Provider Name (Legal Business Name): SENNA HUSBYN RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6019 26TH AVE NW
ROCHESTER MN
55901-8781
US

IV. Provider business mailing address

6019 26TH AVE NW
ROCHESTER MN
55901-8781
US

V. Phone/Fax

Practice location:
  • Phone: 803-606-7410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number2276256
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: