| NPI | 1376200030 |
|---|---|
| Former Name | SHANNON SKOLAUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP1071993) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 872145) |
| 363L00000X Nurse Practitioner (Licence: TX AP1071993) | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2024-08-01 |