Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 01080882A | IN |
N | 207K00000X | Allergist & Immunologist | 036141287 | IL |
N | 207K00000X | Allergist & Immunologist | 35.134300 | OH |
Y | 207K00000X | Allergist & Immunologist | TP837 | KY |
NPI | 1003115502 |
---|---|
Provider Name | Dr. Melissa K Skupin |
First Address | Louisville, KY 40223-2992 |
Second Address | Florence, KY 41042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2011 |
Last Update Date | 26/05/2021 |