Provider Demographics
NPI:1568109445
Name:SKILLMAN, REBECCA LEE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEE
Last Name:SKILLMAN
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 1:341 SAND RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BEULAVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28518-8555
Mailing Address - Country:US
Mailing Address - Phone:910-284-1954
Mailing Address - Fax:
Practice Address - Street 1:341 SAND RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-8555
Practice Address - Country:US
Practice Address - Phone:910-284-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula