Healthcare Provider Details

I. General information

NPI: 1598300451
Provider Name (Legal Business Name): CHARLENE M SKORVANEK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 KOLBE RD STE 120
LORAIN OH
44053-1652
US

IV. Provider business mailing address

3600 KOLBE RD STE 120
LORAIN OH
44053-1652
US

V. Phone/Fax

Practice location:
  • Phone: 440-960-3954
  • Fax: 440-960-3956
Mailing address:
  • Phone: 440-960-3954
  • Fax: 440-960-3956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.025913
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.025913
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: