Provider Demographics
NPI:1811259799
Name:SKINNER, DENISE (CNA)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MRS
Other - First Name:LILA
Other - Middle Name:
Other - Last Name:COLBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCA
Mailing Address - Street 1:174 E WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4536
Mailing Address - Country:US
Mailing Address - Phone:757-718-1539
Mailing Address - Fax:
Practice Address - Street 1:174 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4536
Practice Address - Country:US
Practice Address - Phone:757-718-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide