MEDICARE: MS. ALYSSA SKALITZKY APNP

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
1	363L00000X	Nurse Practitioner	3667-033	WI
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3667-033	WI

General Provider Information

NPI Number	:	1598906596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALYSSA SKALITZKY APNP

Provider Business Mailing Address
First Line	:	1010 35TH ST
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53140-1902
Country	:	US
Telephone Number	:	920-420-6333
Fax Number	:	262-299-7136

Provider Business Practice Location Address
First Line	:	1010 35TH ST
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53140-1902
Country	:	US
Telephone Number	:	262-725-4426
Fax Number	:	262-299-7136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	03/11/2025

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