Provider Demographics
NPI:1942471651
Name:SKINNER, ASHLEE LYNN (PA C)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:LYNN
Last Name:SKINNER
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:LYNN
Other - Last Name:HOWERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA C
Mailing Address - Street 1:PO BOX 2339
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-2339
Mailing Address - Country:US
Mailing Address - Phone:580-225-2511
Mailing Address - Fax:580-225-9143
Practice Address - Street 1:1002 NE HIGHWAY 66 STE 3
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:OK
Practice Address - Zip Code:73662-9312
Practice Address - Country:US
Practice Address - Phone:580-928-9914
Practice Address - Fax:580-928-9913
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200196740AMedicaid
OK200196740AMedicaid
OKOK700613Medicare PIN
OKP00713588Medicare PIN
OKOK400598Medicare PIN
OKOK400623Medicare UPIN