Provider Demographics
NPI:1518716794
Name:SKIBA, LAURA (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SKIBA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 E GREENWAY PKWY APT 2132
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2116
Mailing Address - Country:US
Mailing Address - Phone:602-909-3266
Mailing Address - Fax:
Practice Address - Street 1:6735 E GREENWAY PKWY APT 2132
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2116
Practice Address - Country:US
Practice Address - Phone:602-909-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-18
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ229949363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health