Provider Demographics
NPI:1346357464
Name:SCHESKIE, JULIANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:SCHESKIE
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 1:2090 SARNO RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3077
Mailing Address - Country:US
Mailing Address - Phone:321-608-8888
Mailing Address - Fax:
Practice Address - Street 1:517 SOUTH ARIZONA AVENUE
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:575-538-2981
Practice Address - Fax:575-388-3373
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2007-0009363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM342720502Medicare PIN