Healthcare Provider Details

I. General information

NPI: 1346060563
Provider Name (Legal Business Name): DANA NICOLE SKIPPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANA NICOLE BUCHANAN RN

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 COUNTY ROAD 1332
VINEMONT AL
35179-6726
US

IV. Provider business mailing address

953 COUNTY ROAD 1332
VINEMONT AL
35179-6726
US

V. Phone/Fax

Practice location:
  • Phone: 256-727-3991
  • Fax:
Mailing address:
  • Phone: 256-727-3991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-147528
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: