Provider Demographics
NPI:1881989267
Name:SKOVIRA, KELLY LYNN (CRNP, DNP)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:LYNN
Last Name:SKOVIRA
Suffix:
Gender:F
Credentials:CRNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1507
Mailing Address - Country:US
Mailing Address - Phone:724-875-5637
Mailing Address - Fax:
Practice Address - Street 1:514 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-1507
Practice Address - Country:US
Practice Address - Phone:724-875-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP005173V363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health