Provider Demographics
NPI:1821677717
Name:SKINNER, GINA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 WOODMERE DR APT 8
Mailing Address - Street 2:
Mailing Address - City:NEW STANTON
Mailing Address - State:PA
Mailing Address - Zip Code:15672-9731
Mailing Address - Country:US
Mailing Address - Phone:724-689-6516
Mailing Address - Fax:
Practice Address - Street 1:590 WOODMERE DR APT 8
Practice Address - Street 2:
Practice Address - City:NEW STANTON
Practice Address - State:PA
Practice Address - Zip Code:15672-9731
Practice Address - Country:US
Practice Address - Phone:724-689-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily