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Individual

MARY T SKINNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP-C

Contact information

Practice address
215 CENTRAL AVE STE 100, SUITE 100, LOUISVILLE, KY 40208-1450
(502) 588-8720
(502) 588-8721
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0329
(502) 599-0326

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3005720
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
5720P
KY
363LG0600X
Gerontology Nurse Practitioner
5720P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00706702
RAILROAD MEDICARE
KY
Enumeration date
02/16/2009
Last updated
11/21/2016
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