Healthcare Provider Details

I. General information

NPI: 1336681618
Provider Name (Legal Business Name): JULIE A SKEENS RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE A WALKER

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5170 US RT 60 EAST
HUNTINGTON WV
25705
US

IV. Provider business mailing address

5170 US RT 60 EAST
HUNTINGTON WV
25705
US

V. Phone/Fax

Practice location:
  • Phone: 304-528-4600
  • Fax:
Mailing address:
  • Phone: 304-528-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number66442
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: