Individual
MRS. JENNIFER PENISTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2901 86TH ST, URBANDALE, IA 50322-4201
(515) 276-3406
Mailing address
2901 86TH ST, URBANDALE, IA 50322-4201
(515) 276-3406
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A114664
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093139727
—
IA
01
—
P01353220
RR MEDICARE
IA
Enumeration date
02/17/2014
Last updated
10/13/2014
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