Provider Demographics
NPI:1881009892
Name:SKROCKI, ANDREA DUGAN (APRN)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:DUGAN
Last Name:SKROCKI
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4369 S SCENIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SUTTONS BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9509
Mailing Address - Country:US
Mailing Address - Phone:406-493-2371
Mailing Address - Fax:720-853-0034
Practice Address - Street 1:4369 S SCENIC VIEW DR
Practice Address - Street 2:
Practice Address - City:SUTTONS BAY
Practice Address - State:MI
Practice Address - Zip Code:49682-9509
Practice Address - Country:US
Practice Address - Phone:406-493-2371
Practice Address - Fax:720-853-0034
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0002431-C-NP363LP0808X
COC-RXN-0001254-C-NP363LP0808X
MTNUR-APRN-LIC-100764363LP0808X
MI4704371939363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health