Provider Demographics
NPI:1033163324
Name:SKELTON, JANE ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ANN
Last Name:SKELTON
Suffix:
Gender:F
Credentials:CRNA
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 845
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-0845
Mailing Address - Country:US
Mailing Address - Phone:719-539-0707
Mailing Address - Fax:719-539-7704
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPT. ANESTHESIA ANGIE EDWARDS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-877-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104110367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO800992Medicare ID - Type Unspecified