Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0024178876 | VA |
NPI | 1356974422 |
---|---|
Provider Name | Alexandra Skinner |
First Address | Manassas, VA 20111-3667 |
Second Address | Washington, DC 20010-3017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2020 |
Last Update Date | 27/10/2020 |