Provider Demographics
NPI:1619017415
Name:SKYMBA, JULIE L (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:L
Last Name:SKYMBA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 W KING RD
Mailing Address - Street 2:
Mailing Address - City:FRAZER
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1987
Mailing Address - Country:US
Mailing Address - Phone:610-647-4127
Mailing Address - Fax:
Practice Address - Street 1:8601 STENTON AVE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-8312
Practice Address - Country:US
Practice Address - Phone:215-233-6226
Practice Address - Fax:215-233-6380
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP005314H363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA469907Medicare PIN
PAS70229Medicare UPIN