Provider Demographics
NPI:1114391224
Name:SKIBINSKI, KATHRYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:SKIBINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20251 JOHN J WILLIAMS HWY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4314
Mailing Address - Country:US
Mailing Address - Phone:302-644-6860
Mailing Address - Fax:302-644-6872
Practice Address - Street 1:20251 JOHN J WILLIAMS HWY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4314
Practice Address - Country:US
Practice Address - Phone:302-644-6860
Practice Address - Fax:302-644-6872
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0001177363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant