Provider Demographics
NPI:1891340667
Name:TOBIAS, SKITZY JOY (DNP, RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:SKITZY
Middle Name:JOY
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:DNP, RN, CPNP-PC
Other - Prefix:
Other - First Name:SKITZY
Other - Middle Name:JOY
Other - Last Name:TOBIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2930 FREDERICA CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-9258
Mailing Address - Country:US
Mailing Address - Phone:678-994-4253
Mailing Address - Fax:
Practice Address - Street 1:1790 MULKEY RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1122
Practice Address - Country:US
Practice Address - Phone:404-277-0916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203510363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics