Provider Demographics
NPI:1164836144
Name:SKRIPKO, ABBY MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:MARIE
Last Name:SKRIPKO
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 1:623 POTTSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:LYKENS
Mailing Address - State:PA
Mailing Address - Zip Code:17048-1630
Mailing Address - Country:US
Mailing Address - Phone:570-691-8830
Mailing Address - Fax:
Practice Address - Street 1:1700 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056885363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
357743Medicare PIN