Provider Demographics
NPI:1649817487
Name:SKINNER, LAURA KRISTINE (FNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KRISTINE
Last Name:SKINNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 LINHART AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:NAPAVINE
Mailing Address - State:WA
Mailing Address - Zip Code:98565-1527
Mailing Address - Country:US
Mailing Address - Phone:360-745-2736
Mailing Address - Fax:833-973-5927
Practice Address - Street 1:375 LINHART AVE NE STE A
Practice Address - Street 2:
Practice Address - City:NAPAVINE
Practice Address - State:WA
Practice Address - Zip Code:98565-1527
Practice Address - Country:US
Practice Address - Phone:360-745-2736
Practice Address - Fax:833-973-5927
Is Sole Proprietor?:No
Enumeration Date:2019-11-27
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9771-33363LF0000X
AZ242574363LF0000X
WAAP61375170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2231904Medicaid