Healthcare Provider Details

I. General information

NPI: 1811207046
Provider Name (Legal Business Name): SONDRA SUSAN SKORY RN, MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N. EL PASO ST. BUILDING E
EL PASO TX
79902
US

IV. Provider business mailing address

6609 TARASCAS DR.
EL PASO TX
79912-2417
US

V. Phone/Fax

Practice location:
  • Phone: 915-577-0444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number546801
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: