Provider Demographics
NPI:1477116929
Name:SKANES, EMBRE
Entity Type:Individual
Prefix:MRS
First Name:EMBRE
Middle Name:
Last Name:SKANES
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 1:4450 ABACO DR
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4791
Mailing Address - Country:US
Mailing Address - Phone:321-603-8336
Mailing Address - Fax:
Practice Address - Street 1:4450 ABACO DR
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4791
Practice Address - Country:US
Practice Address - Phone:321-603-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion