Provider Demographics
NPI:1679895890
Name:SKATTUM, LAUREN BRITT (DO)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BRITT
Last Name:SKATTUM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 W 57TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2893
Mailing Address - Country:US
Mailing Address - Phone:605-653-1536
Mailing Address - Fax:605-653-1536
Practice Address - Street 1:1905 W 57TH ST STE 1
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2893
Practice Address - Country:US
Practice Address - Phone:605-653-1536
Practice Address - Fax:605-653-1536
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12665207V00000X
SD13063207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology