Provider Demographics
NPI:1306564372
Name:TRYBUS, SKYE LYNN
Entity type:Individual
Prefix:
First Name:SKYE
Middle Name:LYNN
Last Name:TRYBUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SKYE
Other - Middle Name:LYNN
Other - Last Name:TRYBUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:937 MAGEE RD
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-1809
Mailing Address - Country:US
Mailing Address - Phone:814-691-5491
Mailing Address - Fax:
Practice Address - Street 1:2907 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4305
Practice Address - Country:US
Practice Address - Phone:877-626-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN748757163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice