MEDICARE: LORALAINE ANN SKOWRONSKI RN

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	163WH0200X	Home Health Registered Nurse	101201-30	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821118001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORALAINE ANN SKOWRONSKI RN

Provider Business Mailing Address
First Line	:	1000 S 64TH ST
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53214-3241
Country	:	US
Telephone Number	:	414-732-2458
Fax Number	:

Provider Business Practice Location Address
First Line	:	12250 W NORTH AVE
Second Line	:	APT. 222
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2063
Country	:	US
Telephone Number	:	414-476-5303
Fax Number	:

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/09/2007

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