Individual
JULIA ELIZABETH PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6813 W HIGHWAY 22, CRESTWOOD, KY 40014-7007
(502) 243-2622
(502) 243-2692
Mailing address
6813 W HIGHWAY 22, CRESTWOOD, KY 40014-7007
(502) 243-2622
(502) 243-2692
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3005977
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5977P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000613676
ANTHEM PIN
—
01
—
3005977
APRN LICENSE
KY
01
—
636310
VALUEOPTIONS
—
Enumeration date
06/22/2008
Last updated
09/01/2015
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