Healthcare Provider Details

I. General information

NPI: 1083165278
Provider Name (Legal Business Name): ROBBIN SWANN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBBIN ELLEN HENDERSON RN, IBCLC

II. Dates (important events)

Enumeration Date: 10/22/2016
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 SHILOH RD
TYLER TX
75703-2612
US

IV. Provider business mailing address

2627 S BROADWAY AVE # 8173
TYLER TX
75701-5405
US

V. Phone/Fax

Practice location:
  • Phone: 903-316-1927
  • Fax:
Mailing address:
  • Phone: 903-316-1927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number7-1733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: