Healthcare Provider Details

I. General information

NPI: 1992491658
Provider Name (Legal Business Name): LUCY ELIZA SKINNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

IV. Provider business mailing address

3073 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-7101
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-5461
  • Fax: 603-356-9048
Mailing address:
  • Phone: 603-356-5461
  • Fax: 603-356-9048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMRM-2266
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number39335
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39335
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: