Basic Information
| Provider Information | |||||||||
| NPI: | 1497771851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SKOPEC | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | MARY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MIKKELSEN | ||||||||
| OtherFirstName: | KATHRYN | ||||||||
| OtherMiddleName: | MARY | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 411 10TH STREET SE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524032449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193633600 | ||||||||
| FaxNumber: | 3193639971 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 10TH STREET SE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524032449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193633600 | ||||||||
| FaxNumber: | 3193639971 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 04/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 31253 | IA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.