Healthcare Provider Details

I. General information

NPI: 1487566881
Provider Name (Legal Business Name): NATALIE JADE SKINNER PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 FORREST DR
HANNIBAL MO
63401-5503
US

IV. Provider business mailing address

154 FORREST DR
HANNIBAL MO
63401-5503
US

V. Phone/Fax

Practice location:
  • Phone: 573-221-2120
  • Fax: 573-221-4380
Mailing address:
  • Phone: 573-221-2120
  • Fax: 573-221-4380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026043263
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: