Individual
JASON SHANE SKINNER IRLANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(800) 451-5796
Mailing address
954 S 150TH ST, OMAHA, NE 68154-2811
(860) 617-0360
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
93786
NE
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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