Healthcare Provider Details

I. General information

NPI: 1730042425
Provider Name (Legal Business Name): SKYLER KENNA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 DIPLOMACY DR
ANCHORAGE AK
99508-5926
US

IV. Provider business mailing address

4315 DIPLOMACY DR
ANCHORAGE AK
99508-5926
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number248402
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: