Healthcare Provider Details

I. General information

NPI: 1750837084
Provider Name (Legal Business Name): HOLLY SKOCNY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N RIVERSIDE RD STE 150
SAINT JOSEPH MO
64507-2508
US

IV. Provider business mailing address

4912 N WHEELING AVE
KANSAS CITY MO
64119-3865
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-4025
  • Fax: 816-271-4026
Mailing address:
  • Phone: 619-228-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2016005875
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: