Provider Demographics
NPI:1578276812
Name:SKINAWAY, LINDA LUENE (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LUENE
Last Name:SKINAWAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LUENE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:907 WILLARD ST W
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-5674
Mailing Address - Country:US
Mailing Address - Phone:612-922-4872
Mailing Address - Fax:
Practice Address - Street 1:907 WILLARD ST W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5674
Practice Address - Country:US
Practice Address - Phone:612-922-4872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI106088-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health