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Individual
ANGELA W PENNINGTON
Active
Individual
ANGELA W PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1091574
KY
363L00000X
Nurse Practitioner
Primary
3008028
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3008028
STATE LICENSE
KY
05
—
7100239710
—
KY
Enumeration date
02/18/2013
Last updated
12/07/2020
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