Healthcare Provider Details

I. General information

NPI: 1033702246
Provider Name (Legal Business Name): BRITTANY LOUISE SKINNER C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9485 MENTOR AVENUE SUITE 210
MENTOR OH
44060
US

IV. Provider business mailing address

9485 MENTOR AVENUE SUITE 210
MENTOR OH
44060
US

V. Phone/Fax

Practice location:
  • Phone: 440-255-5571
  • Fax: 440-205-5744
Mailing address:
  • Phone: 440-255-5571
  • Fax: 440-205-5744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0028120
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: