Provider Demographics
NPI:1457488272
Name:SKINNER, CAROL ANNE
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANNE
Last Name:SKINNER
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 1:5606 WOOD LN
Mailing Address - Street 2:
Mailing Address - City:WESCOSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9547
Mailing Address - Country:US
Mailing Address - Phone:610-730-7890
Mailing Address - Fax:
Practice Address - Street 1:5606 WOOD LN
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9547
Practice Address - Country:US
Practice Address - Phone:610-730-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor