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General NPI Number Information
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NPI Number | 1841043668
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Entity Type | Individual
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Provider Name | KENDRA LEIGH SKAGGS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 642 BAXTER AVE APT 318
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City | LOUISVILLE
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State | KY
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Zip | 40204-1992
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Country | US
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Telephone | 502-291-2055
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Fax |
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Provider Business Mailing Address
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Address Line | 1319 DUNCAN AVE
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3759
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Country | US
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Telephone | 812-283-2308
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 4015511
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License Number State | KY
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