Individual
MRS. SHENITA PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6633
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6633
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
L048721
AR
164W00000X
Licensed Practical Nurse
Primary
LPN080991
GA
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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