Healthcare Provider Details
I. General information
NPI: 1235320607
Provider Name (Legal Business Name): JAMES WILLIAM SKINNER MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/09/2007
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 E SUNSHINE ST STE 214
SPRINGFIELD MO
65804-1886
US
IV. Provider business mailing address
2130 S PIN OAK DR
SPRINGFIELD MO
65809-3143
US
V. Phone/Fax
- Phone: 417-262-6609
- Fax: 417-530-1418
- Phone: 417-343-5692
- Fax: 417-530-1418
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 2019033533 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: