Provider Demographics
NPI:1659523520
Name:SKIFFINGTON, CALLIE BALTZ (APN)
Entity Type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:BALTZ
Last Name:SKIFFINGTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11102 SUNRISE BLVD E
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374
Mailing Address - Country:US
Mailing Address - Phone:253-848-8797
Mailing Address - Fax:253-845-0100
Practice Address - Street 1:11102 SUNRISE BLVD E
Practice Address - Street 2:SUITE 103
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374
Practice Address - Country:US
Practice Address - Phone:253-848-8797
Practice Address - Fax:253-845-0100
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00173200363LP0200X
WAAP60100863363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics