Provider Demographics
NPI:1851988786
Name:SKAER, KELLYE LYNN (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KELLYE
Middle Name:LYNN
Last Name:SKAER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 FINN CORNER WAY
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77389-2879
Mailing Address - Country:US
Mailing Address - Phone:936-217-0099
Mailing Address - Fax:
Practice Address - Street 1:79 FINN CORNER WAY
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77389-2879
Practice Address - Country:US
Practice Address - Phone:936-217-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-301982174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-301982OtherIBCLE