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General NPI Number Information
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NPI Number | 1467700419
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Entity Type | Individual
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Provider Name | JOANNA JACQUELINE SKIPPER MD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2012
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 150 N EAGLE CREEK DR
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City | LEXINGTON
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State | KY
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Zip | 40509-1805
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Country | US
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Telephone | 859-967-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1772 COURTNEY AVE
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City | LEXINGTON
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State | KY
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Zip | 40505-4047
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Country | US
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Telephone | 678-913-6388
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R4588
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | TP201
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License Number State | KY
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