Provider Demographics
NPI:1295081685
Name:SKIPPER, ALAN W (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:W
Last Name:SKIPPER
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-5387
Mailing Address - Country:US
Mailing Address - Phone:912-681-9519
Mailing Address - Fax:912-681-9520
Practice Address - Street 1:127 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-5387
Practice Address - Country:US
Practice Address - Phone:912-681-9519
Practice Address - Fax:912-681-9520
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN175214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily