Provider Demographics
NPI:1851777445
Name:SKINNER, HOLLEY ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:HOLLEY
Middle Name:ELIZABETH
Last Name:SKINNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15964 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65625-8985
Mailing Address - Country:US
Mailing Address - Phone:417-236-4660
Mailing Address - Fax:
Practice Address - Street 1:201 W HOLLY ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-2425
Practice Address - Country:US
Practice Address - Phone:870-942-3621
Practice Address - Fax:870-942-7825
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist