Provider Demographics
NPI:1437813979
Name:SKEIRIK, COLLEEN (APRN)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:SKEIRIK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:SKEIRIK
Other - Last Name:VENETOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:6 BUTTRICK RD
Mailing Address - Street 2:STE 102
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:
Practice Address - Street 1:6 TSIENNETO RD STE 100
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1595
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH073935-23207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH073935-23Medicaid