Healthcare Provider Details

I. General information

NPI: 1841255916
Provider Name (Legal Business Name): DONNA ELAINE SKIDGEL F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 HOSPITAL DR SUITE 220
SACRAMENTO CA
95823-5408
US

IV. Provider business mailing address

10057 GARNET AVE
STOCKTON CA
95212-2101
US

V. Phone/Fax

Practice location:
  • Phone: 916-689-3433
  • Fax: 916-689-8943
Mailing address:
  • Phone: 209-931-4702
  • Fax: 916-689-8943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number381184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: