Provider Demographics
NPI:1962470344
Name:SKOLNICK, SARA LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LOUISE
Last Name:SKOLNICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S CAMPUS AVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-2487
Mailing Address - Country:US
Mailing Address - Phone:513-529-3000
Mailing Address - Fax:513-529-1892
Practice Address - Street 1:421 S CAMPUS AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-2487
Practice Address - Country:US
Practice Address - Phone:513-529-3000
Practice Address - Fax:513-529-1892
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP01358363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health