Healthcare Provider Details

I. General information

NPI: 1134969280
Provider Name (Legal Business Name): JENNIFER C SKOW PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 US HIGHWAY 220
MUNCY PA
17756-6561
US

IV. Provider business mailing address

2144 TEABERRY LN
LOCK HAVEN PA
17745-9778
US

V. Phone/Fax

Practice location:
  • Phone: 800-230-4565
  • Fax:
Mailing address:
  • Phone: 570-502-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: