Provider Demographics
NPI:1588946156
Name:SKINNER, DENISE LORENE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:LORENE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 E. STATE RD 44
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-1236
Mailing Address - Country:US
Mailing Address - Phone:317-392-4663
Mailing Address - Fax:317-398-5266
Practice Address - Street 1:2158 INTELLIPLEX
Practice Address - Street 2:SUITE 200
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1236
Practice Address - Country:US
Practice Address - Phone:317-392-4663
Practice Address - Fax:317-398-5266
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004409A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner