Provider Demographics
NPI:1972870632
Name:SKIBO, YUJUNG KIM (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:YUJUNG
Middle Name:KIM
Last Name:SKIBO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:YUJUNG
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:116 NORTHPORT AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 NORTHPORT AVE STE 112
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6096
Practice Address - Country:US
Practice Address - Phone:207-505-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4374363L00000X
OR10021530363LF0000X
NC5016863363LF0000X
MECNP231329363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily