Healthcare Provider Details

I. General information

NPI: 1013716869
Provider Name (Legal Business Name): NICHOLAS LELAND SKIBBA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 DUFF AVE
AMES IA
50010-5469
US

IV. Provider business mailing address

288 CENTRAL PARK CT
HARRISBURG SD
57032-2547
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6048
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number25246
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: