Provider Demographics
NPI:1104031723
Name:SKINNER, YVONNE ANNETTE (NMD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:ANNETTE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-3509
Mailing Address - Country:US
Mailing Address - Phone:520-882-4252
Mailing Address - Fax:520-792-2835
Practice Address - Street 1:2016 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-3509
Practice Address - Country:US
Practice Address - Phone:520-882-4252
Practice Address - Fax:520-792-2835
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ98548208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice