MEDICARE: MISS JULIE LYNNE SKINNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency	1060170-2-AFC	MN

General Provider Information

NPI Number	:	1588098479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIE LYNNE SKINNESS

Provider Business Mailing Address
First Line	:	1803 8TH AVE SW
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-1703
Country	:	US
Telephone Number	:	507-438-1672
Fax Number	:

Provider Business Practice Location Address
First Line	:	1803 8TH AVE SW
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-1703
Country	:	US
Telephone Number	:	507-438-1672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	08/27/2013

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Directions to “ MISS JULIE LYNNE SKINNESS ” Practice Location

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