Healthcare Provider Details

I. General information

NPI: 1841154457
Provider Name (Legal Business Name): LEAH SKIPPER MS,RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803A E THREE NOTCH ST
ANDALUSIA AL
36421-2403
US

IV. Provider business mailing address

1909 RIDGE RD
GREENVILLE AL
36037-6805
US

V. Phone/Fax

Practice location:
  • Phone: 409-767-8100
  • Fax: 888-977-1202
Mailing address:
  • Phone: 334-437-1813
  • Fax: 888-866-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1597
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: