Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 111385 | NE |
NPI | 1497001473 |
---|---|
Provider Name | Elena Kristine Skillett |
First Address | Lincoln, NE 68503-3799 |
Second Address | Lincoln, NE 68503-3799 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2012 |
Last Update Date | 06/09/2012 |