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NPI Code Detail

MEDICARE: CARRIE ANN SKAGGS CRNP

MEDICARE: CARRIE ANN SKAGGS CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerSP010085PA
2363LF0000XFamily Nurse PractitionerSP010085PA
3363LF0000XFamily Nurse PractitionerARNP9406981FL

General Provider Information

NPI Number : 1275778698
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE ANN SKAGGS CRNP
Provider Business Mailing Address
First Line : 1324 LAKELAND HILLS BLVD
Second Line : ATTN: MANAGED CARE DEPT
City : LAKELAND
State : FL
Zip : 33805-4543
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4710 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-2165
Country : US
Telephone Number : 863-284-5000
Fax Number : 863-284-6824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2008
Last Update Date : 05/24/2016

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