Skinner, Shannon E.

Skinner, Shannon E. is an individual health care provider with primary practice located at 2601 E Roosevelt St , Phoenix AZ 85008-4973. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Skinner, Shannon E. can be contacted via phone (602) 344-5892.

Contact Information

Primary practice address
2601 E Roosevelt St Phoenix AZ 85008-4973
Phone: (602) 344-5892
Fax: (602) 344-1488
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 28737 Arizona
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 28737 Arizona

Profile Details

NPI number 1629016514
LBN Legal business name Skinner, Shannon E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Sep 15th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629016514 NPPES
Arizona MEDICAID 561052

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