Individual
HEATHER PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
2600 SAINT MICHAEL DR, TEXARKANA, TX 75503-2372
(903) 614-2989
Mailing address
PO BOX 5193, TEXARKANA, TX 75505-5193
(760) 731-0313
(760) 731-0414
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
597591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090KE
BCBS
TX
Enumeration date
10/25/2006
Last updated
09/03/2015
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