Provider Demographics
NPI:1437747953
Name:SKINNER, DENISE L (LPN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:SKINNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:L
Other - Last Name:DUNHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:154 SAINT CASIMIR ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2447
Mailing Address - Country:US
Mailing Address - Phone:585-369-5119
Mailing Address - Fax:
Practice Address - Street 1:154 SAINT CASIMIR ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2447
Practice Address - Country:US
Practice Address - Phone:585-369-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340197164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse