1447421482 NPI number — MRS. CHRISTIE FAYE SKINNER DNP, APN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447421482 NPI number — MRS. CHRISTIE FAYE SKINNER DNP, APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SKINNER
Provider First Name:
CHRISTIE
Provider Middle Name:
FAYE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUSSELL
Provider Other First Name:
CHRISTIE
Provider Other Middle Name:
FAYE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447421482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2790 SOUTHFIELD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL DORADO
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71730-3462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-864-1611
Provider Business Mailing Address Fax Number:
870-719-3089

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2226 HAYNESVILLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL DORADO
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71730-9712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-864-1611
Provider Business Practice Location Address Fax Number:
870-719-3089
Provider Enumeration Date:
03/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  A03087 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 167235758 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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