Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024166382 | VA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 0024166382 | VA |
NPI | 1013984426 |
---|---|
Provider Name | Elizabeth D Skaggs |
First Address | Roanoke, VA 24014-1838 |
Second Address | Roanoke, VA 24014-1838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 28/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10141915 | (05) | VA |
Q35422 | (02) |