Healthcare Provider Details

I. General information

NPI: 1467752121
Provider Name (Legal Business Name): LAUREN E SKIFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN E TETRAULT

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 EBRIGHT ROAD
WILMINGTON DE
19810
US

IV. Provider business mailing address

P.O. BOX 30170
WILMINGTON DE
19805-7170
US

V. Phone/Fax

Practice location:
  • Phone: 302-477-3960
  • Fax: 610-527-2773
Mailing address:
  • Phone: 215-359-6579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP011040
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: