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NPI Code Detail

MEDICARE: MRS. MARY K SKAATS NP-C

MEDICARE: MRS. MARY K SKAATS NP-C
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
1363LF0000XFamily Nurse PractitionerCOA.12376-NPOH

General Provider Information

NPI Number : 1902190804
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY K SKAATS NP-C
Provider Business Mailing Address
First Line : 8238 PRINCETON GLENDALE RD
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-1675
Country : US
Telephone Number : 513-454-1307
Fax Number : 513-454-1309
Provider Business Practice Location Address
First Line : 731 W MARKET ST
Second Line :
City : TROY
State : OH
Zip : 45373-3003
Country : US
Telephone Number : 937-573-4380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2011
Last Update Date : 05/22/2019

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