Individual
JULIE M PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD0000033935
TN
207ND0900X
Dermatopathology Physician
33935
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3159356
BCBS
TN
Enumeration date
11/30/2005
Last updated
06/09/2014
Update your record
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