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General NPI Number Information
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NPI Number | 1063376192
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Entity Type | Individual
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Provider Name | MARY ANN SKINNER RN
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Gender | Female
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 300 MULBERRY ST STE 503
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City | MACON
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State | GA
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Zip | 31201-5102
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Country | US
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Telephone | 478-476-0444
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Fax | 478-478-8008
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Provider Business Mailing Address
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Address Line | 41 KYNDALL LN
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City | FORSYTH
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State | GA
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Zip | 31029-8747
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Country | US
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Telephone | 478-476-0444
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Fax | 478-478-8008
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN149815
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License Number State | GA
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