Individual
MICHAEL SKIDMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
618 N TANGLEWOOD RD, DERBY, KS 67037-2123
(316) 648-8592
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
127935
KS
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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