Skidmore, Tammy L

Skidmore, Tammy L is an individual health care provider with primary practice located at 777 Hospital Way , Pocatello ID 83201-5175. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Skidmore, Tammy L can be contacted via phone (208) 239-1000.

Contact Information

Primary practice address
777 Hospital Way Pocatello ID 83201-5175
Phone: (208) 239-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X N27623 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RNA-582 Idaho

Profile Details

NPI number 1427008176
LBN Legal business name Skidmore, Tammy L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Nov 1st, 2011 - about 13 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 1427008176 NPPES
Idaho MEDICAID 806817800
Idaho Other 145477
Idaho MEDICAID 200429720A

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