Provider Demographics
NPI:1649457847
Name:SKOG, BARBARA CHASE (RN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:CHASE
Last Name:SKOG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SAGE
Other - Middle Name:
Other - Last Name:SKOG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1010 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2600
Mailing Address - Country:US
Mailing Address - Phone:617-534-4222
Mailing Address - Fax:
Practice Address - Street 1:1010 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2600
Practice Address - Country:US
Practice Address - Phone:617-534-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231754163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care