Provider Demographics
NPI:1952406472
Name:SKINNER, PATRICIA S (RD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:SKINNER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 EYDIE LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-9136
Mailing Address - Country:US
Mailing Address - Phone:985-768-9136
Mailing Address - Fax:
Practice Address - Street 1:1555 POYDRAS ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3701
Practice Address - Country:US
Practice Address - Phone:504-556-7201
Practice Address - Fax:504-556-7356
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA795133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered