Individual
MR. REGGIE DARNELL PENNYPACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
3125 BROOKWOOD AVE, DUNCAN, OK 73533-1362
(580) 786-4018
(580) 786-4021
Mailing address
3125 BROOKWOOD AVE, DUNCAN, OK 73533-1362
(580) 786-4018
(580) 786-4021
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
76980
OK
363LP2300X
Primary Care Nurse Practitioner
76980
OK
Other
Enumeration date
10/03/2013
Last updated
09/13/2024
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