Provider Demographics
NPI:1336538149
Name:SKIPPER, JANINE
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:SKIPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 RIVERVIEW RD APT 5304
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4741
Mailing Address - Country:US
Mailing Address - Phone:251-769-6973
Mailing Address - Fax:
Practice Address - Street 1:25910 CANAL RD STE D
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-5016
Practice Address - Country:US
Practice Address - Phone:251-981-2184
Practice Address - Fax:844-204-4753
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-133894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily