Provider Demographics
NPI:1467463661
Name:SKEENS, PAULA JANE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JANE
Last Name:SKEENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:PAULA
Other - Middle Name:JANE
Other - Last Name:SKEENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:6830 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2503
Practice Address - Country:US
Practice Address - Phone:813-783-3118
Practice Address - Fax:813-355-5036
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9263165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00613233OtherRR MEDICARE
FL308925800Medicaid
FLP00613233OtherRR MEDICARE
FLAK574ZMedicare PIN