Provider Demographics
NPI:1003269747
Name:SKIFF, ANGIE MARIE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:MARIE
Last Name:SKIFF
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:MARIE
Other - Last Name:BLASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 ALASKA AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2012
Mailing Address - Country:US
Mailing Address - Phone:402-750-4712
Mailing Address - Fax:
Practice Address - Street 1:3005 35TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1480
Practice Address - Country:US
Practice Address - Phone:402-942-1329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE978225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation