Healthcare Provider Details

I. General information

NPI: 1538930193
Provider Name (Legal Business Name): ABIGAIL LAUREN SKEENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 GILBERT AVE
CINCINNATI OH
45206-1210
US

IV. Provider business mailing address

1063 FAIR AVE
COLUMBUS OH
43205-1326
US

V. Phone/Fax

Practice location:
  • Phone: 513-815-4475
  • Fax:
Mailing address:
  • Phone: 513-502-6409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0036598
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.520134
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: