Provider Demographics
NPI:1053927236
Name:SKAGGS, SHEENA LOUISE
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:LOUISE
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:WV
Mailing Address - Zip Code:24925-0064
Mailing Address - Country:US
Mailing Address - Phone:681-318-2855
Mailing Address - Fax:
Practice Address - Street 1:37560 MIDLAND TRAIL
Practice Address - Street 2:
Practice Address - City:WHITE SULPHER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:24986
Practice Address - Country:US
Practice Address - Phone:681-318-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant