Active NPI
Lois Skrivanie, RN
- Psychiatric/Mental Health Registered Nurse
- Green Bay, WI
National Provider Identifier
1073740841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 63080-030
- Practice address
- 2640 West Point Rd
Green Bay, WI 54304 - Phone
- (920) 490-3790
- Fax
- (920) 490-3845
- NPI assigned
- Jun 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 63080-030 | WI | Primary |
Addresses
Primary practice location
2640 West Point Rd
Green Bay, WI 54304
Mailing address
2640 West Point Rd
Green Bay, WI 54304
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63080-030 | Other | WI | STATE OF WISCONSIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63080-030 | WI | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245283200000",
"number": "1073740841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2640 WEST POINT RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54304",
"fax_number": "920-490-3845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2640 WEST POINT RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54304",
"telephone_number": "920-490-3790",
"fax_number": "920-490-3845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKRIVANIE",
"first_name": "LOIS",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-18",
"last_updated": "2009-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "WI",
"license": "63080-030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF WISCONSIN",
"identifier": "63080-030",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.