Healthcare Provider Details

I. General information

NPI: 1265707525
Provider Name (Legal Business Name): ALISHA ALEXANDRA SKINNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 B ST STE 200
ANCHORAGE AK
99503-5933
US

IV. Provider business mailing address

601 N BROADWAY
DENVER CO
80203-3407
US

V. Phone/Fax

Practice location:
  • Phone: 907-375-3355
  • Fax: 907-375-3355
Mailing address:
  • Phone: 303-436-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberML60282852
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0055005
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number148028
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: