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Individual

HEATH PENNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
300 E 23RD ST, FREMONT, NE 68025-2302
(402) 727-7990
(402) 727-1761
Mailing address
1040 N BELL ST., FREMONT, NE 68025-4347
(402) 727-7990
(402) 727-1761

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
100904
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
911765978-15
NE
Enumeration date
11/07/2006
Last updated
03/05/2012
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