Provider Demographics
NPI:1376273938
Name:SKEELS, SANDRA LEE ANN
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE ANN
Last Name:SKEELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RIVER RANCH RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-7848
Mailing Address - Country:US
Mailing Address - Phone:830-431-8599
Mailing Address - Fax:
Practice Address - Street 1:125 RIVER RANCH RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-7848
Practice Address - Country:US
Practice Address - Phone:830-431-8599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171725164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse