Healthcare Provider Details

I. General information

NPI: 1184401093
Provider Name (Legal Business Name): LENORE SKINNER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HILYARD ST STE 310
EUGENE OR
97401-8122
US

IV. Provider business mailing address

1200 HILYARD ST STE 570
EUGENE OR
97401-8168
US

V. Phone/Fax

Practice location:
  • Phone: 458-205-6709
  • Fax: 458-205-6708
Mailing address:
  • Phone: 458-205-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10015741
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: