Provider Demographics
NPI:1619591575
Name:SKINNER, KATIE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 HUTCHINSON AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4751
Mailing Address - Country:US
Mailing Address - Phone:440-567-8069
Mailing Address - Fax:
Practice Address - Street 1:324 HUTCHINSON AVE APT 311
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4751
Practice Address - Country:US
Practice Address - Phone:440-567-8069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0026813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily