Provider Demographics
NPI:1003300930
Name:MCSKIMMINGS, MICHELLE J (CSA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:MCSKIMMINGS
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102826
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-2826
Mailing Address - Country:US
Mailing Address - Phone:720-273-8828
Mailing Address - Fax:
Practice Address - Street 1:820 NEWTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3030
Practice Address - Country:US
Practice Address - Phone:720-273-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant