Healthcare Provider Details

I. General information

NPI: 1407438203
Provider Name (Legal Business Name): KATHLEEN MARIE SKEENS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN MARIE WILMES MD

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PLEASANT VALLEY RD
OWENSBORO KY
42303-9811
US

IV. Provider business mailing address

PO BOX 860912
ROCHESTER MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 270-417-5911
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number77519
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number62253
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number85896
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number33367
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: