Healthcare Provider Details

I. General information

NPI: 1346692035
Provider Name (Legal Business Name): AMANDA SKELTON APRN FNP-BC ANVP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 W PROSPER TRL STE 720
PROSPER TX
75078-4357
US

IV. Provider business mailing address

1630 W PROSPER TRL STE 720
PROSPER TX
75078-4357
US

V. Phone/Fax

Practice location:
  • Phone: 682-559-1956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberAP131199
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP131199
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: