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General NPI Number Information
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NPI Number | 1972990828
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Entity Type | Individual
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Provider Name | ANDREA LEE SKATES FNP
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Gender | Female
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Dates
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Enumeration Date | 04/17/2015
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 3935 N 75 W
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City | HYDE PARK
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State | UT
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Zip | 84318-4111
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Country | US
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Telephone | 435-359-0720
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Fax | 833-992-1993
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Provider Business Mailing Address
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Address Line | 57 N 1100 E
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City | SMITHFIELD
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State | UT
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Zip | 84335-2515
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Country | US
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Telephone | 205-492-0088
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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 | 93804704405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 93804708900
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9380470-4405
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License Number State | UT
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