Provider Demographics
NPI:1932998200
Name:DUNHAM, SKYLAR NICOLE
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:NICOLE
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-1001
Mailing Address - Country:US
Mailing Address - Phone:330-617-2996
Mailing Address - Fax:
Practice Address - Street 1:1111 9TH ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-1001
Practice Address - Country:US
Practice Address - Phone:330-617-2996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant