Healthcare Provider Details

I. General information

NPI: 1093632341
Provider Name (Legal Business Name): ALLISON SKINNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N SENATE BLVD
INDIANAPOLIS IN
46202-1239
US

IV. Provider business mailing address

8201 S DYSON DR
NINEVEH IN
46164-9772
US

V. Phone/Fax

Practice location:
  • Phone: 317-962-8880
  • Fax:
Mailing address:
  • Phone: 812-447-5397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28222991A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: