Provider Demographics
NPI:1568161784
Name:SKEENS, AMANDA ANN (RN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANN
Last Name:SKEENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9405
Mailing Address - Country:US
Mailing Address - Phone:304-550-6130
Mailing Address - Fax:
Practice Address - Street 1:173 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9405
Practice Address - Country:US
Practice Address - Phone:304-550-6130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV58604163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator