Provider Demographics
NPI:1760948996
Name:SKINNER, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 ROCHELL AVE APT 1812
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1420
Mailing Address - Country:US
Mailing Address - Phone:202-422-1884
Mailing Address - Fax:
Practice Address - Street 1:4020 MINNESOTA AVE NE APT 324
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3525
Practice Address - Country:US
Practice Address - Phone:202-702-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant