Individual
ANDREA LEE SKATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3935 N 75 W, HYDE PARK, UT 84318-4111
(435) 359-0720
(833) 992-1993
Mailing address
57 N 1100 E, SMITHFIELD, UT 84335-2515
(205) 492-0088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9380470-4405
UT
363LF0000X
Family Nurse Practitioner
93804704405
UT
363LF0000X
Family Nurse Practitioner
93804708900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972990828
—
UT
Enumeration date
04/17/2015
Last updated
08/14/2020
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