# SKYLINE MEDICAL PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Skyline Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356951628
- **Authorized official:** CHELSEY DEVER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (843) 697-5168

## Contact information

- **Practice address:** 841 N SHENANDOAH AVE, FRONT ROYAL, VA 22630-3501
- **Practice address phone:** (540) 636-7000
- **Practice address fax:** (540) 636-7029
- **Mailing address:** 841 N SHENANDOAH AVE, FRONT ROYAL, VA 22630-3501
- **Mailing address phone:** (540) 636-7000
- **Mailing address fax:** (540) 363-7029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/03/2020
- **Last updated:** 07/18/2024