Provider Demographics
NPI:1447136510
Name:SKAGGS, MICHELE (HIS)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SKAGGS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4570 PECAN DR STE A
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-6717
Mailing Address - Country:US
Mailing Address - Phone:270-349-3392
Mailing Address - Fax:270-554-6995
Practice Address - Street 1:4570 PECAN DR STE A
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6717
Practice Address - Country:US
Practice Address - Phone:270-554-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY291980237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist