Basic Information
| Provider Information | |||||||||
| NPI: | 1821568825 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SKOWRONSKA | ||||||||
| FirstName: | MAGDALENA | ||||||||
| MiddleName: | KINGA | ||||||||
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| Credential: | MSN, APRN, FNP-C, CE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 MIRROR LAKE DR | ||||||||
| Address2: | STE A | ||||||||
| City: | ORMOND BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321743102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3866732500 | ||||||||
| FaxNumber: | 3866733204 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 MIRROR LAKE DR STE A | ||||||||
| Address2: | |||||||||
| City: | ORMOND BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321743102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3866732500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2018 | ||||||||
| LastUpdateDate: | 05/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 11000302 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 363LF0000X | 11000302 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.