Provider Demographics
NPI:1578131876
Name:SKOW, ADDIE (NP)
Entity Type:Individual
Prefix:
First Name:ADDIE
Middle Name:
Last Name:SKOW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 FARRINGTON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9900
Mailing Address - Country:US
Mailing Address - Phone:984-999-0902
Mailing Address - Fax:
Practice Address - Street 1:5915 FARRINGTON RD STE 106
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9900
Practice Address - Country:US
Practice Address - Phone:984-999-0902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC241278163WS0200X
NC5014725.363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WS0200XNursing Service ProvidersRegistered NurseSchool