Healthcare Provider Details

I. General information

NPI: 1790599025
Provider Name (Legal Business Name): MORGAN LEE SKUBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S LAKE PARK AVE
HOBART IN
46342-6699
US

IV. Provider business mailing address

524 DUNEWOOD DR
CHESTERTON IN
46304-3131
US

V. Phone/Fax

Practice location:
  • Phone: 219-947-6200
  • Fax: 219-947-6220
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28259281
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: