Provider Demographics
NPI:1376377705
Name:SKAGGS, KATHERINE NICOLE (RNC-MNN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:NICOLE
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:RNC-MNN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 WESTBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-3313
Mailing Address - Country:US
Mailing Address - Phone:804-307-2169
Mailing Address - Fax:
Practice Address - Street 1:1613 WESTBROOK AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-3313
Practice Address - Country:US
Practice Address - Phone:804-307-2169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001231836163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant