Provider Demographics
NPI:1366303570
Name:SKINNER, TERRY JR (APRN-BC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:SKINNER
Suffix:JR
Gender:X
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72823-4709
Mailing Address - Country:US
Mailing Address - Phone:479-264-5720
Mailing Address - Fax:
Practice Address - Street 1:807 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:ATKINS
Practice Address - State:AR
Practice Address - Zip Code:72823-4709
Practice Address - Country:US
Practice Address - Phone:479-264-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235244363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care