Provider Demographics
NPI:1629732557
Name:SKONIECZNY, KATHRYN AMY (MSN, APRN, CPNP-AC)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:AMY
Last Name:SKONIECZNY
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP-AC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:AMY
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7601 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7601 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3214
Practice Address - Country:US
Practice Address - Phone:469-303-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054320363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics