# MISS PENNICA MARIE MUMFORD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205394822
- **Gender:** F
- **Credential:** BSN,MSN, RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WA2000X | Administrator Registered Nurse | RN168735 | GA | — |
| 163WC0400X | Case Management Registered Nurse | RN168735 | GA | — |
| 163WC1600X | Continuing Education/Staff Development Registered Nurse | RN168735 | GA | — |
| 163WG0000X | General Practice Registered Nurse | RN168735 | GA | Yes |
| 163WG0600X | Gerontology Registered Nurse | RN168735 | GA | — |
| 163WI0500X | Infusion Therapy Registered Nurse | RN168735 | GA | — |
| 163WN1003X | Nutrition Support Registered Nurse | RN168735 | GA | — |
| 163WP0807X | Child & Adolescent Psychiatric/Mental Health Registered Nurse | RN168735 | GA | — |
| 163WP0809X | Adult Psychiatric/Mental Health Registered Nurse | RN168735 | GA | — |
| 163WW0000X | Wound Care Registered Nurse | RN168735 | GA | — |

## Other

- **Enumeration date:** 03/04/2019
- **Last updated:** 03/04/2019