Basic Information
| Provider Information | |||||||||
| NPI: | 1841667730 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SKOMP | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73698 314 AVE | ||||||||
| Address2: | |||||||||
| City: | LAMAR | ||||||||
| State: | NE | ||||||||
| PostalCode: | 690232037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088833020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 E JOHNSON ST | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 807341854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9708542500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2015 | ||||||||
| LastUpdateDate: | 08/26/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | C-APN.0000403-C-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.