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General NPI Number Information
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NPI Number | 1851874929
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Entity Type | Individual
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Provider Name | DONNA T SKINNER FNP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 2613 W 98TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-3237
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Country | US
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Telephone | 708-925-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 BUELL AVE
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City | JOLIET
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State | IL
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Zip | 60435-6851
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Country | US
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Telephone | 708-925-2613
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.002590
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License Number State | IL
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