Provider Demographics
NPI:1548635063
Name:SKEATE, TARA (CRMA, PSS)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:SKEATE
Suffix:
Gender:F
Credentials:CRMA, PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04643-3041
Mailing Address - Country:US
Mailing Address - Phone:207-598-8668
Mailing Address - Fax:207-483-8100
Practice Address - Street 1:57 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04643-3041
Practice Address - Country:US
Practice Address - Phone:207-598-8668
Practice Address - Fax:207-483-8100
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERCC2376374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide