Healthcare Provider Details

I. General information

NPI: 1861297269
Provider Name (Legal Business Name): BRITTANY PAIGE SKORNICKA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 JOHN R ST
DETROIT MI
48201-2018
US

IV. Provider business mailing address

3990 JOHN R ST
DETROIT MI
48201-2018
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-8040
  • Fax:
Mailing address:
  • Phone: 512-786-8643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704386648
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: